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PODCAST

GeriPal - A Geriatrics and Palliative Medicine Podcast

Alex Smith, Eric Widera

A geriatrics and palliative medicine podcast for every health care professional. Two UCSF doctors, Eric Widera and Alex Smith, 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. CME and MOC credit available (AMA PRA Category 1 credits) at www.geripal.org

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All Episodes

50:07

Pragmatic Trial to Increase Advance Care Planning:...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2026/04/02

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 without needing to read the chart or use natural language processing). This study focused on patients

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46:25

CMS's Age-Friendly Hospital Measure: Julia...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2026/03/26

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 this new measure with Sheri Ling, CMS's Deputy Chief Medical Officer serving in the Center for Clinical

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51:51

De-intensify Anti-Hypertensives for Nursing Home...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2026/03/19

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 without changing mortality, that must be what the authors concluded. I was shocked, therefore, to read in the

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52:28

Alzheimer's Definitions, Biomarkers, and Antibodies:...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2026/03/12

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, we sit down with dementia experts Halima Amjad, Barak Gaster, and Heather Whitson. We dive deep into:

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51:15

Leadership, Quality, and the Future of Hospice:...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2026/03/05

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 host Cordt Kassner, CEO of Hospice Analytics, which provides in depth data on hospice quality, utilization,

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47:51

Deprescribing at the End of Life: Jennifer Tija, Jon...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2026/02/26

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 receive at least one unnecessary medication near the end of life, including drugs like

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50:24

Unilateral DNR? Gina Piscitello, Erin DeMartino, Will...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2026/02/19

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 ECMO offered? Is the assent of a family member to a statement that we will not code their loved one a

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47:15

Embedding Care in the ED: Liz Goldberg and Lauren...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2026/02/12

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 for the patient who is malnourished and dehydrated and admitted for "failure to thrive," again. And

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52:28

AI and Healthcare: Bob Wachter

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2026/02/05

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 discuss: Why Bob wrote this book, at this time, and concerns about writing a static book about AI and

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46:02

The Role of Specialty Palliative Care in Cancer...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2026/01/29

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 SCOPE and PERIOP-PC trials. Null trials like these often receive less attention in academic and clinical

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47:05

The Future of Palliative Care? Community-Based Models...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2026/01/22

"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 margins. After listening to today's podcast on the growth of community-based palliative care, I find my

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51:12

Uncertainty In Medicine: Jonathan Ilgen and Gurpreet...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2026/01/15

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, co-authors of the New England Journal of Medicine article, "Educational Strategies to Prepare Trainees

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52:43

Why We Need QI Collaboratives: Guests Steve Pantilat,...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2026/01/08

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 leading experts in the field—Drs. Steve Pantilat, David Currow, and Arif Kamal—who bring invaluable

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49:02

Is Attending to Clinician Distress Our Job? Sara...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/12/18

Have you had one of those consults in which you're thinking, huh, sounds like the patient's goals are clear, it's really that the clinician consulting us disagrees with those goals? To what extent is it our job as consultants to navigate, manage, or attend to clinician distress? What happens when that clinician distress leads eventually to conflict between the consulting clinician and the palliative care team? Today our guests Sara Johnson, Yael Schenker, & Anne Kelly discuss these issues,

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49:21

Rehab and Death in Skilled Nursing Facilities:...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/12/11

In this week's podcast, we sit down with Drs. Sarguni Singh, Christian Furman, and Lynn Flint, three authors of the recent Journal of the American Geriatrics Society article, "Rehab and Death: Improving End-of-Life Care for Medicare Skilled Nursing Facility Beneficiaries." The authors dive into the challenges facing seriously ill older adults discharged to Skilled Nursing Facilities (SNFs), where fragmented care transitions, misaligned Medicare policies, and inadequate access to palliative care

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50:51

Inflammaging: Brian Andonian, Sara LaHue, Joe...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/12/04

Six years ago we had John Newman on GeriPal to talk about Geroscience (Song choice Who Wants to Live Forever by Queen, perfect selection). John explained the basics of geroscience, what is it, what are the key theories in geroscience, what is senescence, why people who provide clinical care for older adults should care about geroscience, and potential therapeutics like metformin and rapamycin. Today we bring on three rising stars in Geroscience, Brian Andonian, Sara LaHue, Joe Hippensteel, to talk

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46:17

The Chaplain and the Doctor: A Podcast with Betty...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/11/20

In this week's episode, we delve into the powerful documentary The Chaplain and The Doctor with two extraordinary guests: Betty Clark, the chaplain at the heart of the film, and Dr. Jessica Zitter, the physician and filmmaker who brought this story to the screen. The film provides a deeply moving look into the ways personal stories and biases shape our interactions in healthcare. Through our conversation with Betty and Jessica, I gained a valuable insight: the narratives we carry within

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53:05

A Strategic Path Forward for Hospice & Palliative...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/11/13

In June of 2025, hospice and palliative care pioneer Ira Byock published a white paper outlining the urgent challenges facing the field today. In a nutshell, he expressed concerns that the quality of hospice care in the United States has become highly variable, with disturbing frequency of unethical practices and avaricious owners. He also raised concern that the rapid increase in palliative care program growth during the first two decades of this century has stalled, leaving us with understaffed

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47:58

Palliative Care in Sickle Cell: Craig Blinderman,...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/11/06

Today's topic on palliative care for sickle cell disease may raise eyebrows with some of you. You might think, wait, now we're doing sickle cell? On top of liquid cancer and transplant, kidney disease, liver disease, and survivorship? Where does it end? Do we have staff for all of this? Well I implore you, dear listeners, to keep an open mind and listen to this podcast. Our guests do a fabulous job of stating the case for palliative care in sickle cell disease, to the point that we ask: why

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43:36

Medical Billing and Coding in Geriatrics: Peter...

GeriPal - A Geriatrics and Palliative Medicine Podcast ·

2025/10/30

Last month, the "Billing Boys"—Chris Jones and Phil Rodgers—joined the GeriPal podcast to demystify medical billing and coding in palliative care. This month, we're back with part two, shifting the focus to geriatrics. While billing and coding may not be the most exciting topic, they're essential for ensuring fair reimbursement for the complex care we provide and for supporting the work of our interprofessional teams, many of whom can't bill directly for their services. When we underbill or leave

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