Key Perspectives

How do we determine whether a patient truly has the capacity to make their own medical decisions? In this episode of Key Perspectives, Eric Gordon, PA-C and Steve Arze, MD dive into one of the most common and ethically complex challenges in geriatrics, palliative care, and acute medicine: assessing medical decision-making capacity. The discussion focuses on three widely used, evidence-based framew...

Pain is one of the most common and overlooked drivers of behavioral and psychological symptoms of dementia. In this episode of Key Perspectives, we continue our BPSD series as Eric Gordon and Dr. Steve Arze discuss how unrecognized pain often shows up as agitation, vocalization, or resistance to care in patients who cannot reliably communicate their discomfort. We explore why pain is so frequently...

In Part 2 of our series on Behavioral and Psychological Symptoms of Dementia (BPSD), Eric Gordon, PA-C, and Dr. Steve Arze dive into one of the toughest clinical challenges in geriatrics and post-acute care: when and how to use medications to treat behavioral symptoms in dementia. Building on last episode’s discussion of non-pharmacologic strategies, this conversation tackles the realities of pres...

In this first of a two-part series, Eric Gordon, PA-C, and Dr. Steve Arze break down practical, evidence-based strategies for managing Behavioral and Psychological Symptoms of Dementia (BPSD) without reaching for the prescription pad. They clarify the key differences between BPSD and delirium, introduce the “Five P’s” framework for uncovering unmet needs, and explore real-world tools like redirect...

In this milestone tenth episode of Key Perspectives, Eric Gordon, PA-C, and Dr. Arze explore the art of “narrating your care”, a simple but powerful way clinicians can bridge the gap between clinical excellence and patients’ perception of excellence. Too often, patients leave an encounter uncertain about what was done, why it was done, or when to expect results. Eric and Dr. Arze unpack why vague...

In this episode, we wrap up our heart failure series with a practical, case-based discussion. Building on the foundation of diagnostics, fluid management, and guideline-directed medical therapy covered in earlier episodes, we bring it all together by working through real-world patient scenarios. We explore: Case 1: A new diagnosis of HFrEF in a patient with multiple comorbidities. Case 2: Medicati...

In this episode of Key Perspectives, we continue our heart failure series with Part 6: a deep dive into SGLT2 inhibitors. Originally developed for diabetes, these medications have become essential tools in managing both HFrEF and HFpEF, regardless of whether a patient has diabetes. We’ll explore how SGLT2 inhibitors work, their surprising benefits in heart failure and chronic kidney disease, and t...

In this fifth installment of our Heart Failure series, we dive deep into one of the core pillars of guideline-directed medical therapy (GDMT) for patients with HFrEF: Beta Blockers. You’ll learn: How beta-1, beta-2, and beta-3 adrenergic receptors work Why slowing the heart rate helps in HFrEF The evidence-based beta blockers for HFrEF (and their dosing) Common pitfalls in prescribing, like confus...

In this episode, we take a thoughtful, practical look at a topic that’s often misunderstood: hospice care. Whether you’re a clinician, caregiver, or simply someone trying to navigate the complexities of serious illness, this episode offers clarity on what hospice really is—and isn’t.   We cover: What hospice care truly entails from a clinical and insurance perspective The full range of support ser...

In this fourth installment of our heart failure series, we dive into another essential pillar of guideline-directed medical therapy (GDMT): the renin-angiotensin system (RAS) inhibitors. This includes ACE inhibitors, ARBs, and ARNIs—cornerstones of treatment for patients with heart failure with reduced ejection fraction (HFrEF). Join us as we unpack how RAS inhibitors work, when to initiate therap...

In this episode of Key Perspectives, we continue our heart failure series by diving into Part 3: Medication Management, with a focus on spironolactone, a cornerstone of guideline-directed medical therapy (GDMT). We start by reviewing the distinctions between HFpEF, HFmrEF, and HFrEF, and discuss how treatment strategies differ across these subtypes. The hosts explain what GDMT is, who develops it,...

In this episode, we kick off our deep dive into heart failure treatment, starting with a fundamental goal: achieving ideal volume status. Managing fluid overload is crucial for symptom control and preventing hospitalizations — and today, we’re unpacking how to do it effectively. We'll cover: Dry Weight: What it is, why it matters, and how to determine it. Fluid Restriction: When and why. Loop Diur...

In this first installment of our multi-part series on Heart Failure (HF), we dive into why this condition deserves such focused attention—especially in older adults. Of the 5 million patients in the US that have heart failure, more than 75% of them are 65+. Understanding the nuances of this chronic, progressive disease is essential for clinicians in geriatric care. Join us as we break down how to...

In this episode, we explore the essential aspects of introducing yourself to new patients, both on a personal and professional level. We discuss how to effectively communicate your role in the care team, set expectations for patient care across different settings, and navigate the challenges of transitioning care, whether it’s a new patient, a transfer, or a follow-up visit. Tune in for valuable i...