GeriPal - A Geriatrics and Palliative Medicine Podcast

Who's better at delivering palliative care to patients with liver disease: palliative care specialists, or hepatologists who have received liver disease-specific palliative care training?   That's the question we take a deep dive into on this week's podcast by breaking down the PAL-LIVER trial, published this year in JAMA Internal Medicine. We've invited three of the trial's authors, Manisha Verma...

Emergency Podcast! Our guests Sean Morrison, Ken Covinsky, and Stacy Fischer believe that you should care deeply about the proposed shakeup at the National Institutes of Health.  Major proposed rules changes at the Office of Management and Budget, would affect a huge range of government grants, from Headstart to Transportation to the National Science Foundation, as well as the National Institutes...

Today's podcast is a natural follow up to our podcasts on Slow Codes and Unilateral DNR orders .Today we talk about a new study about how clinicians talk about potentially non-beneficial life-prolonging treatments , published in JAMA Network Open. Do they adhere to society guidelines, which allow as permissible approaches only shared decision-making and following institutional policy.  Or do they...

Today we revisit a topic we last discussed in a 2020 podcast with Laura Mosqueda : elder mistreatment.  Our guests today are geriatricians Carrie Rubenstein and Julia Hiner, and Tony Rosen, an emergency medicine doctor. They talk about where we are now, in 2026, with elder mistreatment, including: Terminology: elder mistreatment vs. abuse and neglect The need to incorporate prevention and solution...

Two retired luminaries in geriatrics join us today to share their personal experiences. First, John Burton, a geriatrician and Director of the Division of Geriatric Medicine at Johns Hopkins for some 35 years, shares his journey moving into a Continuing Care Retirement Community (CCRC) during Covid.  You can read about John's early experiences in his JAGS commentary titled, "Waiting for the Other...

Our focus today is on the search for the geriatrician identity, a continuation of the conversation we started with Jerry Gurtwitz on the Future of Geriatrics .  Today's conversation is prompted by multiple articles in JAGS: (1) an article by Jerry Gurwitz with a title the same as this podcast; (2) an article by Helen Fernandez on " Med-Geri ", a new combined 4 year internal medicine residency and...

I had the privilege of learning from fellow Greenwall Faculty Scholar Lisa Harris about a term she termed, " dangertalk ."  As an ob/gyn and abortion provider, Lisa found the debate around the legality of abortion so polarizing that it created a false dichotomy: you're either for or against.  Any talk about misgivings, uncertainty, ambiguity, or ambivalence was silenced.  Talking about these issue...

While we have previously discussed brain death criteria on the GeriPal Podcas t, we have yet to explore the complex landscape families face regarding organ donation. In this episode, we dive into the nuances of Donation after Brain Death (DBD) and Donation after Circulatory Death (DCD), and clarify the essential role of healthcare providers who are not part of an organ procurement organization. In...

In this episode of the GeriPal podcast, we dive into the fascinating world of geriatric dermatology, or "GeriDerm," with two exceptional guests: Dr. Daniel Butler from the University of Arizona and Dr. Eleni Linos from Stanford University .  First, we tackle the big question: how do we keep our skin healthy as we age? I see this on a daily basis with my own skin, but I'm unsure what to do about it...

Eric and I were delighted to be invited to Brazil to give a series of presentations in Sao Paulo at their annual geriatrics meeting.  We met people doing important, interesting, and innovative work in Brazil and throughout Latin America. We got the audience to sing along, including (in another talk) the magnificent Brazilian song Sozinho by Caetano Veloso in Portuguese, with my son Renn playing gu...

Lynn Flint and Anne Kelly join as hosts in a reprise of last year's ask us anything format.  Thank you for sending in your terrific questions!  Lynn and Anne condensed them to about 20, and we ran through them rather rapid fire.  Also on fire? Our mouths.  As with our 300th episode, we did this Hot Ones-style . Every few questions, we had to eat a chicken wing slathered in hot sauce.  The hot sauc...

Rural populations in the United States face unique healthcare challenges. These communities tend to be older, have higher mortality rates, and experience higher rates of chronic conditions and physical disabilities compared to urban populations. Despite the increased need for palliative care in rural areas, access remains alarmingly limited. Even in hospital settings, where palliative care program...

Today we're delighted to talk with Anne Walling, Neil Wenger, and Rebecca Sudore about a pragmatic implementation trial aimed at increasing advance care planning for primary care patients with serious illness in University of California clinics, published in Annals of Internal Medicine . Seriously ill primary care patients were identified using structured data fields (meaning routinely captured wi...

In 2025, the Centers for Medicare and Medicaid Services (CMS) began requiring hospitals participating in the Hospital Inpatient Quality Reporting (IQR) program to report on a new "Age-Friendly Hospital Measure."  The hope is that, by attesting to this measure, hospitals will develop evidence-based processes to improve care for older adults in hospital settings. On this week's podcast, we explore t...

A few weeks ago, I was skimming this NEJM paper for UCSF's Division of Geriatrics Journal club on de-prescribing anti-hypertensive medications for older adults in nursing homes. Seemed to make a world of sense. The  study found no difference between the deprescribing arm and the usual care arm in mortality, the primary study outcome. I thought, great! So we can deprescribe anti-hypertensives witho...

It's an era of breakthroughs in Alzheimer's research, yet for many clinicians, it's also a time of profound uncertainty. We are currently navigating competing definitions of the disease, multiple new biomarkers coming on market seemingly every week, and the clinical rollout of new amyloid antibodies. How do we translate this rapid-fire science into daily practice? On this week's GeriPal podcast, w...

Today we're doing something different. Today, dear listeners, you get two podcasts for the price of one! (OK, our podcasts are both free, but you get the idea). We're joined today by Chris Comeaux, host of TCN Talks , a podcast about leadership, strategy, innovation, and the future of serious illness care, and author of The Anatomy of Leadership . We are also joined by TCN Talks' frequent guest ho...

Philippe Pinel remarked in 1800 that "It is an art of no little importance to administer medicines properly, but it is an art of much greater and more difficult acquisition to know when to suspend or altogether to omit them." This insight remains profoundly relevant today, especially in hospice care, where inappropriate prescribing is a common issue. Studies show that 20%–70% of hospice patients r...

Do you think your hospital should allow unilateral DNR orders? Under what circumstances? Through what process?  Do you think that when you obtain the assent of a family to not code their loved one, that assent DNR should be counted as a unilateral DNR order? Should we document unilateral DNR and the rationale? Why for DNR, when we don't document unilateral dialysis not offered, or unilateral no EC...

The idea of embedding various forms of non-emergency care in the emergency department makes a WORLD of sense.  If an older adult comes into the ED with a fall, the minimum the ED has to do is address the fall injury and send them out. But many emergency providers realize this is often a band aid.  They see that patient again the next time they fall.  And again.  And again.  The same could be said...

Today we interviewed Bob Wachter about his book, " A Giant Leap: How AI Is Transforming Healthcare and What That Means for Our Future ."  You may recall we interviewed Bob in April 2024 about AI , and at that time he was on the fence about AI - more promise or more peril for healthcare?  As his book's title suggests, he's come down firmly on the promise side of the equation.  On our podcast we dis...

Recent randomized controlled trials have shown that routine perioperative palliative care does not improve outcomes for patients undergoing curative-intent cancer surgery. No, that wasn't a typo. Regardless of how the data were analyzed, the findings remained consistent: perioperative palliative care DID NOT improve outcomes in the only two randomized controlled trials conducted in this area—the S...

"I just want to say one word to you.  One word.  Plastics… There's a great future in plastics." This iconic line from the movie The Graduate is at the top of my mind when I think about where we are heading in healthcare. I've interpreted "plastics" as symbolizing a dystopian, mass-produced future of medicine—where artificiality and inauthenticity dominate in the pursuit of efficiency and profit ma...

The only certainty in medicine is uncertainty. It touches every aspect of clinical practice, from diagnosis to treatment to prognosis. Despite this, many clinicians view uncertainty as something to tolerate at best or eliminate at worst. But what if we need to rethink and reframe our relationship with uncertainty in medicine? In this episode, we sit down with Jonathan Ilgen and Gurpreet Dhaliwal,...

In a recent episode of the GeriPal podcast, we explored whether the field of palliative care is in need of saving —and, if so, how to save it—with guests Ira Byock, Kristi Newport, and Brynn Bowman. Today, we shift focus to one actionable way to improve palliative care: through quality improvement (QI) collaboratives, registries, and benchmarking.  To guide this discussion, we've invited three lea...