GeriPal - A Geriatrics and Palliative Care Podcast artwork

GeriPal - A Geriatrics and Palliative Care Podcast

304 episodes - English - Latest episode: 22 days ago - ★★★★★ - 138 ratings

A geriatrics and palliative care podcast for every health care professional.

We invite the brightest minds in geriatrics, hospice, and palliative care to talk about the topics that you care most about, ranging from recently published research in the field to controversies that keep us up at night. You'll laugh, learn and maybe sing along. Hosted by Eric Widera and Alex Smith. CME available!

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Episodes

End-of-Life Doulas: A Podcast with Jane Euler, Beth Klint, and John Loughnane

March 07, 2024 07:45 - 43 minutes - 59.2 MB

In the last several years, I’ve seen more and more articles about end-of-life doulas (like this NY Times article from 2021). Despite this, in my 20-year career as a palliative care physician, I have yet to see a death doula in the wild. I’m unsure what they do, how often they’re used, and who pays for their work. So, on today’s podcast, we try to get to the bottom of what exactly is an end-of-life doula. We’ve invited two death doulas, Jane Euler and John Loughnane (who is also a family do...

GeriPal 300th Episode: Ask Me Anything Hot Ones Style

February 29, 2024 07:45 - 43 minutes - 60.1 MB

Today we celebrate eight years, around 2 million listens, and 300 podcasts!    Eric and I take questions from you, our listeners, about: why we podcast, our most controversial podcast, which podcast changed our practice, favorite song request, should all nursing home residents complete the POLST, expanding access to durable medical equipment, palliative care in rural regions, do we have an advance directive, what we’d do to improve healthcare with 7 trillion dollars, treatment for poor a...

Psychological Issues in Palliative Care: Elissa Kozlov and Des Azizoddin

February 22, 2024 07:45 - 45 minutes - 62.8 MB

In our podcast with palliative care pioneer Susan Block, she identified the psychological/psychiatric aspects of palliative care as the biggest are of need for improvement.  As she said, when you think about the hardest patients you’ve cared for, in nearly all cases there was some aspect of psychological illness involved.  That rings true to me. Today we talk with two psychologists who are deeply invested in addressing psychological aspects of care for people living with serious illness. E...

EMS Intervention to Reduce Falls: Carmen Quatman and Katie Quatman-Yates

February 15, 2024 07:45 - 45 minutes - 62.5 MB

We've talked about Falls a couple of times on this podcast, most recently with Tom Gill about the STRIDE study and before that with Sarah Szanton about the CAPABLE study.  A takeaway from those podcasts is that fresh innovative thinking in the falls prevention space is welcome. Today we talk with the twin sister power duo of Carmen Quatman and Katie Quatman-Yates about an intervention that is both brilliant and (in retrospect) should have been obvious.  The insight started when Carmen, an ...

The Nature of Suffering: BJ Miller and Naomi Saks

February 08, 2024 07:45 - 52 minutes - 72 MB

In 1982 Eric Cassell published his landmark essay: On the Nature of Suffering and the Goals of Medicine.  Though his narrow definition of suffering as injured or threatened personhood has been critiqued, the central concept was a motivating force for many of us to enter the fields of geriatrics and palliative care, Eric and I included. Today we talk about suffering in the many forms we encounter in palliative care.  Our guests are BJ Miller, palliative care physician and c-founder of Mettl...

RCT of Default Inpatient PC Consults: Kate Courtright & Scott Halpern

February 02, 2024 07:45 - 47 minutes - 65 MB

Last week we talked about a trial of a nurse and social worker outpatient palliative care intervention published in JAMA.  This week, we talk about the other major palliative care trial of default palliative care consults for hospitalized older adults with COPD, kidney disease, or dementia, published in the same issue of JAMA. (See also our accompanying editorial, first author Ashwin Kotwal who joins today as a co-host, and a podcast I recorded with JAMA editor Preeti Malani). For context, ...

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

January 25, 2024 07:45 - 51 minutes - 71.2 MB

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.  The article we discuss today, also published in JAMA, addresses these two gaps. David Bekelman conducted a RCT of a nurse and social worker telephone intervention (ADAPT intervention) for people...

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

January 18, 2024 07:45 - 52 minutes - 72 MB

The CDC’s Guideline for Prescribing Opioids for Chronic Pain excludes those undergoing cancer treatment, palliative care, and end-of-life care. In doing so, it seems to give the impression that pain seen in cancer is inherently different than pain seen in other conditions and that those with cancer may not have the same risk for opioid use disorder as compared to other conditions. Today's podcast tackles these issues and more with three amazing guests: Katie Jones, Jessica Merlin, and Devo...

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

January 11, 2024 07:45 - 52 minutes - 48.3 MB

Four percent of deaths in Canada are due to Medical Assistance in Dying (MAID).  Four percent. The number of people who have used MAID in Canada since it was legalized in 2016 has increased year on year from about 1,000 people in the first year to over 13,000 people in 2022. California, which has a similar population size as Canada and legalized MAID around the same time, has fewer than 1000 deaths per year from MAID.  In further contrast to the United States, MAID in Canada is almost...

Guiding an Improved Dementia Experience (GUIDE) Model: A Podcast with Malaz Boustani and Diane Ty

December 21, 2023 07:45 - 53 minutes - 48.8 MB

We’ve talked a lot about comprehensive dementia care on the GeriPal podcast but while the evidence is clear that these programs work, the uptake has been limited largely because there hasn't been a strong financial case for it. 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 o...

Influence of Hospital Culture on Intensity of Care: Liz Dzeng

December 14, 2023 07:45 - 47 minutes - 43.2 MB

One of the things I love about Liz Dzeng’s work is the way in which it draws upon, echoes, and advances our understanding of the influence of culture on the end of life experience.  This field is not new. In his book The Hour of our Death Philip Aries described a long evolution in western civilization of cultural attitudes towards dying.  More recently Sharon Kaufman 's book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influence...

Aging and Climate Change: Karl Pillemer, Leslie Wharton, & Ruth McDermott-Levy

December 07, 2023 07:45 - 47 minutes - 43.4 MB

To my teenagers, climate change is an existential crisis.  It’s the end of the world as we know it.  They decry the lack of serious attention and prioritization this issue has in the US.  My kids ask - why don’t adults care about this issue the same way that they and their friends care about it?  My kids have taught me that the emphasis on personal responsibility (reduce your carbon footprint!) was supported by the fossil fuel industry, because it shifted responsibility for change from indus...

Redefining Alzheimer's Disease: A Podcast with Heather Whitson, Jason Karlawish, Lon Schneider

December 01, 2023 07:45 - 51 minutes - 47.2 MB

There is a growing push to change how we define Alzheimer's disease from what was historically a clinically defined syndrome to a newer biological definition based on the presence of positive amyloid biomarkers. This proposed new definition, championed by the Alzheimer's Association (AA) and the National Institute on Aging (NIA), proposes that the disease exists when the earliest manifestation of Alzheimer’s pathophysiology can be detected (amyloid), even though onset of symptoms may be year...

Should you have a coach? Greg Pawlson, Beth Griffiths, & Vicky Tang

November 09, 2023 07:45 - 43 minutes - 39.7 MB

Coaching is in.  During the later stages of the pandemic, it seemed every other person, and particularly the junior faculty in our Division, were either being coached, in training to coach, or coaching others.  When I was a junior faculty, coaching wasn’t a thing.  Sure, Atul Gawande wrote about coaching in surgery - having someone observe you and coach you on your technical skills- but that’s a far cry from the coaching programs focused on empowerment that are exploding around the country t...

The Future of Geriatrics: A Podcast with Jerry Gurwitz, Ryan Chippendale, and Mike Harper

November 02, 2023 06:45 - 51 minutes - 47.3 MB

What does the future hold for geriatrics? I’ve seen this question come up a lot since finishing fellowship nearly two decades ago. Historically, answers generally lamented the ever increasing need for geriatrics without a corresponding growth in the number of specialists in the field. But, it's also hard not to be bullish on the future of the field to see the consistent strides geriatrics has made in the last two decades in improving care for older adults. For example, I never would have ima...

Palliative Rehab?!?: Ann Henshaw, Tamra Keeney, and Sarguni Singh

October 26, 2023 06:45 - 51 minutes - 46.7 MB

Often podcasts meet clinical reality.  That’s why we do this podcast- to address real world issues in palliative care, geriatrics, and bioethics.  But rarely does the podcast and clinical reality meet in the same day. 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.  Physical therapy had walked with him that day and noted improvement...

POLST Evidence and Update: Kelly Vranas, Abby Dotson, Karl Steinberg, and Scott Halpern

October 19, 2023 06:45 - 52 minutes - 47.6 MB

What level of evidence do we need for POLST to use it ourselves, to advocate for wider usage, and for establishing POLST completion as a quality metric?  The answers to these questions will vary.  Reasonable people will disagree.  And today, on our podcast, our guests disagree.  Firmly.  AND we are delighted that our guests modeled respectful disagreement.  With no hard feelings.  Respectful disagreement is in short supply these days. Our guests today are Kelly Vranas, pulm crit care doc w...

Surgical Communication: A Podcast with Gretchen Schwarze, Justin Clapp and Alexis Colley

October 12, 2023 06:45 - 51 minutes - 47.5 MB

For surgeons and patients, deciding if and when to operate can be challenging. Often, the way surgeons communicate about these decisions doesn’t make things any easier for themselves or their patients. And, surgeons often spend the majority of their conversations with patients describing anatomical details and exactly how they plan to ‘fix it’, with little discussion of what that ‘fix’ will do for a patient’s overall goals. Instead, what if your surgeon told you that the operation she was ...

The Language of Serious Illness: A Podcast with Sunita Puri, Bob Arnold, and Jacqueline Kruser

October 05, 2023 06:45 - 46 minutes - 42.3 MB

Communicating about a serious illness is hard. Last week’s podcast we talked about the challenge around miscommunication in serious illness. This week we dive into the challenges with communication when it comes to life sustaining treatments and CPR. Take for example the simple question: “If her breathing gets any worse, she will need to be intubated.” This seems like an innocuous statement of fact, but does she really “need” to be intubated if, for example, her primary goals are to be c...

Miscommunication in Medicine: A podcast with Shunichi Nakagawa, Abby Rosenberg and Don Sullivan

September 28, 2023 06:45 - 49 minutes - 45.1 MB

Medical communication is tough, although fundamentally at its most basic unit of delivery, it includes really only three steps. First, a clinician’s thoughts must be encoded into words, then transmitted often via sounds, and finally decoded back to thoughts by a patient or family member. Simple, right? Not so much, as each one of these steps is fraught with miscommunication. For example, a surgeon may want to convey that all visible tumors were removed during surgery, but transmits that me...

Black/African American Caregivers of Older Adults Living with Dementia: Podcast with Fayron Epps and Karen Moss

September 21, 2023 06:45 - 47 minutes - 43.9 MB

The proportion of people living with dementia who identify as Black/African Americans is on the rise, and so too are the proportion of caregivers who identify as Black/African American.  As our guests talk about today, caregiving for people living with dementia takes a tremendous toll, and when this toll is set atop the challenges of racism in all its forms, the reality of caregiving while Black can be overwhelming. Today we talk with Fayron Epps and Karen Moss, two nurse researchers who...

Hospital-at-Home: Bruce Leff and Tacara Soones

September 14, 2023 06:45 - 50 minutes - 46.5 MB

Hospitals are hazardous places for older adults. These hazards include delirium, malnutrition, falls, infections, and hospital associated disability (which about ⅓ of older adults get during a hospital stay).  What if, for at least some older adults who need acute-level care, instead of treating them in the hospital, we treat them at home? That’s the focus of the hospital-at-home movement, and the subject we talk about in this week’s podcast. We talk with Bruce Leff and Tacara Soones about...

Time for Geriatric Assessments in Cancer Care: William Dale, Mazie Tsang, and John Simmons

September 07, 2023 06:45 - 56 minutes - 51.4 MB

The comprehensive geriatric assessment is one of the cornerstones of geriatrics.  But does the geriatric assessment do anything?  Does it improve outcomes that patients, caregivers, and clinicians care about? Evidence has been mounting about the importance of the geriatric assessment for older adults with cancer, the subject of today’s podcast.  The geriatric assessment has been shown in two landmark studies (Lancet and JAMA Oncology) to reduce high grade toxicity, improve patient and car...

Normalcy, introspection, & the experience of serious illness: Bill Gardner, Juliet Jacobsen, and Brad Stuart

August 31, 2023 06:45 - 51 minutes - 47.3 MB

How do people react when they hear they have a serious illness?  Shock, “like a car is rushing straight at me” (says Bill Gardner on our podcast).  After the shock?  Many people strive, struggle, crawl even back toward a “normal” life.  And some people, in addition or instead, engage in deep introspection on how to make meaning or live with or understand this experience of serious illness.  Today we talk with deep thinkers about this issue.  Bill Gardner is a psychologist living with advan...

Dignity at the End of Life: A Podcast with Harvey Chochinov

August 24, 2023 06:45 - 50 minutes - 46.1 MB

I hear the word dignity used a lot in the medical setting, but I’m never sure what people mean when they use it.  You’d imagine that as a seasoned palliative care doc, I’d have a pretty good definition by now of what “maintaining dignity” or “loss of dignity” means, but you’d be sadly wrong. Well that all changes today as we’ve invited the world's foremost expert in dignity at the end of life, Dr. Harvey Max Chochinov, to join us on the podcast.  Harvey is probably best known for his work ...

Amyloid Antibodies and the Role of the Geriatrician: Nate Chin, Sharon Brangman, and Jason Karlawish

August 17, 2023 06:45 - 50 minutes - 46.3 MB

It's been over two years since one of the worst product launches of all time - Aduhelm (aducanumab).  Praised by the FDA, Alzheimer’s Association (AA), and Pharma as a “game changer”, but derided by others for the drug’s lack of clinical efficacy, risk of severe adverse effects, absence of diversity in trial populations, high costs, and an FDA approval process that was in the kindest words “rife with irregularities”. Instead of Biogen’s expected billions of dollars of revenue from Aduhelm, t...

Sleep problems and Insomnia in Serious Illness: A Podcast with Cathy Alessi and Brienne Miner

July 27, 2023 06:45 - 42 minutes - 38.9 MB

Insomnia. We’ve all had it. Lying in bed at 2 am staring at the ceiling, getting anxious every hour that you’re not falling asleep as you have a busy day coming up. Insomnia sucks.  Chronic insomnia sucks even more. For those with serious illness, sleep problems and insomnia are all too common.  Instead of reflexively jumping to melatonin or ambien, on today's podcast we talk with two sleep experts, Cathy Alessi and Brienne Miner, about a better approach to sleep problems and insomnia. W...

Telemedicine in a Post-Pandemic World: Joe Rotella, Brook Calton, Carly Zapata

July 20, 2023 06:45 - 50 minutes - 46.3 MB

There’s a saying, “never let a crisis go to waste.”  The pandemic was horrific in many ways.  One positive change that came about was the lifting of restrictions around the use of telemedicine.  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 homeb...

Jumpstarting Goals of Care Convos: Erin Kross, Bob Lee, and Ruth Engelberg

July 13, 2023 06:45 - 47 minutes - 43.7 MB

Today’s podcast is a follow up to our 2018 podcast with Randy Curtis about the Jumpstart intervention.  On that podcast he and collaborators tested a combined patient and clinician facing communication priming intervention to promote goals of care conversations.  Today we discuss a new paper in JAMA that tests a stripped down version of the clinician only facing intervention in a pragmatic randomized trial for older adults with serious illness and those 80+.  They found a difference of 4% in...

How State and Local Agencies on Aging Help Older Adults: A Podcast with Susan DeMarois, Greg Olsen, and Lindsey Yourman

July 06, 2023 06:45 - 48 minutes - 44.8 MB

You may have heard of Area Agencies on Aging, but do you really know what they do or how they do it?  What about State Departments of Aging or state master plans for aging?  Do you know how these agencies fit in with programs like Meals-on-Wheels or other nutritional support programs? Is your brain hurting yet with all these questions?  No?  Ok, what about Aging and Disability Resource Connection (ADRC) services? Well, if you are like me, you’ve probably heard of these programs but are at ...

Hospice in Prison Part 2: An interview with the Pastoral Care Workers

June 29, 2023 06:45 - 46 minutes - 42.8 MB

I don't know 'bout religion I only know what I see And in the end when I hold their hand It's both of us set free These are the ending lyrics to Bonnie Raitt’s song “Down the Hall”, an ode to the Pastoral Care Workers who care for their fellow inmates in the hospice unit at the California Medical Facility in Vacaville, California. On last week’s podcast we interviewed the medical director and the chaplain of the prison’s hospice unit (Hospice in Prison Part 1).  This week we turn our at...

Hospice in Prison Part 1: An interview with Michele DiTomas and Keith Knauf

June 22, 2023 06:45 - 53 minutes - 48.9 MB

    In the early 1990’s, California Medical Facility (CMF) created one of the nation’s first licensed hospice units inside a prison. This 17-bed unit serves inmates from all over the state who are approaching the end of their lives. A few are let out early on compassionate release.  Many are there until they die. Today’s podcast is part one of a two-part podcast where we spend a day at CMF, a medium security prison located about halfway between San Francisco and Sacramento, and the hos...

Artificial Intelligence: Charlotta Lindvall, Matt DeCamp, Sei Lee

June 15, 2023 06:45 - 49 minutes - 45.3 MB

Artificial Intelligence, or AI, has tremendous potential.  We talk on this podcast about potential uses of AI in geriatrics and palliative care with natural language processing guru Charlotta Lindvall from DFCI, bioethicists and internist Matt DeCamp from University of Colorado, and prognosis wizard Sei Lee from UCSF. Social companions to address the epidemic of loneliness among older adults Augmenting ability of clinicians by taking notes Searching the electronic health record for data ...

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

June 08, 2023 06:45 - 46 minutes - 52.6 MB

Diabetes is common.  When I’m on nursing home call, the most common page I receive is for a blood sugar value.  When I’m on palliative care consults and attending in our hospice unit we have to counsel patients about deprescribing and de-intensifying diabetes medications.  Given how frequent monitoring and prescribing issues arise in the care of patients with diabetes in late life, including the end of life, Eric and I were excited when Tamryn Gray emailed us requesting a follow up podcast...

Group ACP and Equity: Sarah Nouri, Hillary Lum, LJ Van Scoy

May 25, 2023 06:45 - 48 minutes - 44.1 MB

Our guests today present an important rejoinder to the argument that we should refocus away from advance care planning (ACP).  Sarah Nouri, Hillary Lum, and LJ Van Scoy argue that diverse communities are asking for ACP.  Sarah Nouri gives an example from her work in the LGBTQ+ community of a trans woman who was buried as a man because existing laws/rules did not protect her wishes.  Others cited the call from communities to meet them where they are - be they senior centers, Black-owned busin...

AGS Beers Criteria for Potentially Inappropriate Medication Use: A Podcast with Todd Semla and Mike Steinman

May 18, 2023 06:45 - 45 minutes - 41.9 MB

Hot off the press is a brand spanking new updated 2023 AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.  The Beers Criteria is one of the most frequently cited reference tools in geriatrics, detailing potentially inappropriate medications to prescribe to older people. We’ve invited two members who helped update the criteria including Todd Semla and Mike Steinman.   We discuss a little history of the Beers criteria, including the original Beers Criteria that...

Prevention of Dementia: Kristine Yaffe

May 11, 2023 06:45 - 46 minutes - 42.5 MB

We’ve had multiple GeriPal episodes about treatments for dementia, including aducanumab (here, here, and here) and lecanemab (here).  As today’s guest, Kristine Yaffe notes, part of the reason for that emphasis is that in the US we prioritize treatment, whereas other countries are ahead of us in prioritizing prevention.  Deb Barnes and Kristine Yaffe published a landmark paper in Lancet Neurology finding that up to half of dementia risk is due to modifiable factors.  If we focused on preve...

Why is working with adolescents and young adults so hard? Abby Rosenberg, Nick Purol, Daniel Eison, & Andrea Thach

May 04, 2023 06:45 - 49 minutes - 45.2 MB

I haven’t worked with many adolescents and young adults (AYA, roughly teens to twenties).  But when I have, I find that they’re often some of the hardest patients to care for.  Why?  We talk about why it’s so hard with Abby Rosenberg (chief of PC at DFCI and Boston Childrens), Nick Purol (clinical social worker at DFCI and Boston Childrens), Daniel Eison (pediatric PC doc and co-host of PediPal).  We are grateful to Andrea Thach (PC doc at Sutter East Bay) for bringing this topic to our atte...

GeriPal Special: Hopes and Worries for Hospice and Palliative Care

April 27, 2023 06:45 - 11 minutes - 10.5 MB

We have a special extra podcast this week.  During the last AAHPM - HPNA meeting in Montréal, we went around asking attendees what one thing that they are most worried about and one thing they are most hopeful for when thinking about the future of our field.  We couldn’t fit everyone’s responses in but came up with the big themes for questions and edited them into this weeks podcast / YouTube video.  Eric and Alex   DISCLAIMER While we filmed in Montreal during the Annual Assembly,...

Aging and Homelessness: Margot Kushel

April 20, 2023 06:45 - 53 minutes - 49 MB

In 1990 11% of homeless persons were older than 50.  Today half are over age 50.  Today we talk with Margot Kushel about how we got here, including: That sense of powerlessness as a clinician when you “fix up” a patient in the hospital, only to discharge them to the street knowing things will fall apart. Chronic vs acute homelessness What is the major driver of homelessness in general?   What is the major driver of the increase in older homeless persons? Why do we say “over 50” is “olde...

The importance of social connection: Julianne Holt-Lunstad, Thomas Cudjoe, & Carla Perissinotto

April 13, 2023 06:45 - 43 minutes - 39.4 MB

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. Experiencing social isolation, the objective lack of contact with friends, family, or the community, or loneliness, the subjective feeling of lacking companionship or feeling left out, may be signs that our overall social life is struggling. But, should we as clinicians care ...

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

April 06, 2023 06:45 - 48 minutes - 44.4 MB

Do we need an RCT to establish the worth of chaplaincy? Einstein once said, “Everything that can be counted does not necessarily count; everything that counts cannot necessarily be counted.” 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.” On the other hand, all of our guests agr...

Storytelling in Medicine: A Podcast with Liz Salmi, Anne Kelly, and Preeti Malani

March 30, 2023 06:45 - 50 minutes - 45.8 MB

Two weeks ago on the GeriPal podcast we talked about why and how to write for the general public.  This week we’ve invited three guests to share their stories about storytelling that’s written for healthcare providers. The first guest is Liz Salmi.  Liz wrote a fabulous perspectives piece in the NEJM titled “Deciding on My Dimples” which talks about her experience as a patient doing shared decision making during neurosurgery for resection of an astrocytoma.   In addition to this being a f...

Is Hospice Losing Its Way: A Podcast with Ira Byock and Joseph Shega

March 24, 2023 18:43 - 51 minutes - 47.3 MB

In November of 2022, Ava Kofman published a piece in the New Yorker titled “How Hospice Became a For-Profit Hustle.”  Some viewed this piece as an affront to the amazing work hospice does for those approaching the end of their lives by cherry picking stories of a few bad actors to paint hospice is a bad light. For others, this piece, while painful to read, gave voice to what they have been feeling over the last decade - hospice has in some ways lost its way in a quest of promoting profit ov...

Writing for the Lay Public: Rosanne Leipzig and Louise Aronson

March 16, 2023 06:45 - 47 minutes - 43.2 MB

So you want to write a book. So you want to write a book!  So…you want to write a book?!? Today we talk with two geriatricians: Rosanne Leipzig, author of Honest Aging: An Insider's Guide to the Second Half of Life; and Louise Aronson, author of Elderhood: Redefining Aging, Transforming Medicine, and Reimagining Life. (You can hear our prior podcast on Louise’s book here).  We talk with them about writing for the lay public, including: Why write a book for the lay public? Why write a...

Psychedelics - reasons for caution: Stacy Fischer, Brian Anderson, Theora Cimino

March 09, 2023 07:45 - 48 minutes - 44.2 MB

Psychedelics are having a moment.  Enthusiasm is brimming.  Legalization is moving forward in several states, following the lead of Oregon and Colorado.  FDA is considering approval, shifting away from Schedule I restrictions, paving the way for use in clinical practice.  Potential use in palliative care, chronic pain, and for mood disorders is tantalizing. Early data on efficacy in patients with anxiety and demoralization are promising.  Research is exploding.  Two of our guests today, St...

Gabapentinoids - Gabapentin and Pregabalin: Tasce Bongiovanni, Donovan Maust and Nisha Iyer

March 02, 2023 07:45 - 48 minutes - 44 MB

Gabapentin is the 10th most prescribed drug in the United States and use is increasing.  In 2002, 1% of adults were taking gabapentinoids (gabapentin and or pregabalin).  By 2015 that number increased to 4% of US adults. There are a lot of reasons that may explain the massive increase in use of these drugs.  One thing is clear, it is not because people are using it for FDA approved indications.  The FDA-approved indications for gabapentin are only for treating patients with partial seizure...

Involving the inner circle: Emily Largent, Anne Rohlfing, Lynn Flint & Anne Kelly

February 23, 2023 07:45 - 46 minutes - 42.3 MB

You know when you walk out of a patient's room and have that sense, “This isn’t going to go well.” The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle.  Should you stop at “no?”  Today we talk with Anne Rohlfing, Lynn Flint, and Anne Kelly, authors of a JGIM article on the reasons we shouldn’t stop at “no.”  We owe it to the patient to explore the reasons behind the “no,” commonly not wanting to be a burden to their family.  ...

The Angry Patient: A podcast with Dani Chammas and Keri Brenner

February 16, 2023 07:45 - 55 minutes - 51.1 MB

Think about the last time a patient yelled at you in anger.  How did you react?  The last time this happened to me I immediately went on the defensive despite years of training in serious illness communication skills.  Afterwards, I thought there must be a better way. Well on today’s podcast we invite two of our favorite palliative care psychiatrists, Dani Chammas and Keri Brenner, to teach us about going beyond simple communication skills like naming the emotion when interacting with the ...

What can we learn from simulations? Amber Barnato

February 09, 2023 07:45 - 49 minutes - 44.9 MB

Amber Barnato is an expert in simulation studies.  A health services researcher and palliative care physician, Amber lauds the ability of simulation studies to isolate one variable in a study.  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. In one room the physician under study interacts with a white patient-actor, and in another room interacts with a Black patient-actor.  T...

Guests

BJ Miller
1 Episode
Mike Wasserman
1 Episode

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