HIV, Aging, and Palliative Care: Peter Selwyn and Meredith Greene
GeriPal - A Geriatrics and Palliative Medicine Podcast
Release Date: 05/01/2025
The Chaplain and the Doctor: A Podcast with Betty Clark and Jessica Zitter
GeriPal - A Geriatrics and Palliative Medicine Podcast
In this week’s episode, we delve into the powerful documentary 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 ourselves—whether conscious or unconscious—act as invisible forces that influence how we engage with patients and...
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A Strategic Path Forward for Hospice & Palliative Care: Ira Byock, Kristi Newport, Brynn Bowman
GeriPal - A Geriatrics and Palliative Medicine Podcast
In June of 2025, hospice and palliative care pioneer Ira Byock . 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 programs that are often inadequately trained. Along with Ira, we’ve invited Kristi Newport, a palliative care doctor and Chief Medical Officer of the , and Brynn...
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Palliative Care in Sickle Cell: Craig Blinderman, Stephanie Kiser, Eberechi Nwogu-Onyemkpa
GeriPal - A Geriatrics and Palliative Medicine Podcast
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 , , and ? 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 haven’t we been doing this all along? Our guests today are Craig Blinderman, Stephanie Kiser, Eberechi Nwogu-Onyemkpa, three palliative...
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Medical Billing and Coding in Geriatrics: Peter Hollmann, Ken Koncilja, and Audrey Chun
GeriPal - A Geriatrics and Palliative Medicine Podcast
Last month, the “Billing Boys”—Chris Jones and Phil Rodgers—joined the GeriPal podcast to . 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 money on the table, we not only shortchange ourselves but also devalue the critical role of geriatrics in the healthcare system. This time,...
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Rethinking Slow Codes: Gina Piscitello, Parker Crutchfield, Jason Wasserman
GeriPal - A Geriatrics and Palliative Medicine Podcast
I’m going to begin with a wonderful quote from a recent editorial in by our guests Parker Crutchfield & Jason Wasserman. This quote illustrates the tension between the widely held view in bioethics that slow codes are unethical, and the complexity of real world hospital practice: “Decisive moral positions are easy to come by when sitting in the cheap seats of academic journals, but a troubling ambivalence is naturally characteristic of live dilemmas.” Gina Piscitello, our third guest, recently surveyed doctors, nurses and others at 2 academic medical centers about slow codes. ...
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GeriPal Live! at NPCRC Foley Retreat: Dio Kavalieratos, Prasanna Ananth, Alexi Wright
GeriPal - A Geriatrics and Palliative Medicine Podcast
This is the second GeriPal podcast we’ve recorded live using this format, see this to our prior podcast at the Center to Advance Palliative Care (CAPC) meeting in Philadelphia. Also look for our upcoming podcast recorded live from the . Today we join you from beautiful Banff, Alberta, Canada at the National Palliative Care Research Center () annual Kathleen Foley retreat. This meeting was bittersweet. I’ve been fortunate to attend every meeting in one capacity or another since 2006. The made an enormous impact on the growth and capacity for palliative care...
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GeriPal Live! at CAPC: Karen Bullock, Kim Curseen, Matt Gonzales
GeriPal - A Geriatrics and Palliative Medicine Podcast
Eric and I had the pleasure of doing a GeriPal Live! Podcast as the closing keynote for the recent in Philadelphia PA. For this podcast, we invited 3 guests to each select an article of interest to them, and engage in a discussion about the article, including questions from the CAPC attendees in the audience. Our guests chose the following articles (in the order discussed) Matt Gonzales used AI to select an article by Ravi Parikh on , published in JAMA Network Open, finding 44% in the intervention arm received palliative care consults, vs 8% in the control arm. We discussed use of AI...
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Pre-Operative Geri Assessment: Vicky Tang and Houman Javedan
GeriPal - A Geriatrics and Palliative Medicine Podcast
We love getting requests from listeners for podcast topics. This request came from geriatricians we met at the annual American Geriatrics Society meeting in Chicago. They wanted to know more about what a geriatrician should do in a pre-operative risk assessment. So we invited Vicky Tang and Houman Javedan, two geriatricians and leaders in the pre-operative assessment and prehab space, to talk with us. As is our style, we backed up to some bigger questions, including: -Why do patients need a geriatric assessment pre-operatively?-Why are our surgical colleagues asking...
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What Makes a Good Death? Karen Steinhauser, Rasa Mikelyte, Edison Vidal
GeriPal - A Geriatrics and Palliative Medicine Podcast
What is a “good death”? How should we define it, and who gets to decide? Is the concept of a “good death” even useful? Twenty-five years ago, Karen Steinhauser published a groundbreaking study in JAMA that transformed my understanding of what it means to have a good death and questioned the usefulness of the term itself. This study examined the factors that are important at the end of life for patients, families, physicians, and other healthcare providers. In today’s podcast, we are honored to have Karen join us to discuss this pivotal study and the nature of a “good death”. We...
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Medical Billing and Coding with the "Billing Boys"
GeriPal - A Geriatrics and Palliative Medicine Podcast
A podcast on medical billing and coding??? Ok, hear us out as we were skeptical too. We’ve invited the Billing Boys, Chris Jones and Phil Rodgers, who convinced us of the following: Billing is complicated, but it isn’t hard. Effectively billing helps pay for the interprofessional team members who often can't bill We should know our worth and bill for it. Just because a visit didn’t feel HARD to a well-trained provider doesn’t mean it wasn’t complex or valuable. Many of us have long suffered from low professional self-esteem when it comes to money, and it’s high...
info_outlinePeter Selwyn, one of today’s guests, has been caring for people living with HIV for over 40 years. In that time, care of people with HIV has changed dramatically. Initially, there was no treatment, then treatments with marginal efficacy, complex schedules, and a tremendous burden of side effects and drug-drug interactions. The average age at death was in the 30s.
Now, more people in the US die with HIV rather than from HIV. Treatment regimens are simplified, and the anti-viral drugs are well tolerated. People are living with HIV into advanced ages. The average age at death is likely in the 60s. Nearly half of people living with HIV are over age 55. One in 10 people with newly diagnosed HIV is an older adult. Our second guest, Meredith Greene, is a geriatrician and researcher who focuses on care of older adults living with HIV, in the US and Africa.
On today’s podcast we discuss:
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Implications of aging with HIV for clinical care
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Loneliness and social isolation among older adults living with HIV
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Persistence of stigma
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Need to consider HIV in the differential diagnosis for older adults
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Screening for HIV
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Screening for osteoporosis in people living with HIV
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Dementia and cognitive impairment risk in people living with HIV
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When to stop anti-virals near the end of life
Toward the end we speak to the moment. More older adults live with HIV in SubSaharan Africa and the global South than anywhere else in the world. Funding for research and clinical care is at risk, as USAID and PEPFAR (which is under USAID), are shuttered. Millions of lives are at stake. Meredith wore a shirt that said Silence=death.
Eric gave me the hook during my live cover of One, by U2, a song released in 1992 whose proceeds went entirely to AIDS research. I couldn’t help it, forgive me dear listeners, I had to do a longer than usual cut at the start!
-Alex Smith
Useful links:
Peter's article on the evolution of HIV: https://link.springer.com/article/10.1007/s11524-011-9552-y
Peter’s book Surviving the Fall: Personal Journey of an AIDS Doctor
PEPFAR: Global Health Policy | KFF
Articles:
Geriatric Syndromes in Older HIV-Infected Adults - PMC
Loneliness in Older Adults Living with HIV
Management of Human Immunodeficiency Virus Infection in Advanced Age
https://pmc.ncbi.nlm.nih.gov/articles/PMC3684249/
About Act-up for those who might know the Silence=Death t-shirt reference:
https://www.npr.org/2021/06/16/1007361916/act-up-a-history-of-aids-hiv-activism
https://www.newyorker.com/magazine/2021/06/14/how-act-up-changed-america