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Individualizing Blood Pressure Goals in Older Adults: A Podcast with Mitra Jamshidian, Simon Ascher and Mark Supiano

GeriPal - A Geriatrics and Palliative Medicine Podcast

Release Date: 07/10/2025

AI and Healthcare: Bob Wachter show art AI and Healthcare: Bob Wachter

GeriPal - A Geriatrics and Palliative Medicine Podcast

Today we interviewed Bob Wachter about his book, “.”  You may recall we , 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 Healthcare, a field that is dynamic and shifting rapidly.  He’s right though - we’ve not had a “ChatGPT”-launch type moment recently. Top 5 or so ways in which Bob uses AI for work,...

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The Role of Specialty Palliative Care in Cancer Surgery: Rebecca Aslakson & Myrick Shinall show art The Role of Specialty Palliative Care in Cancer Surgery: Rebecca Aslakson & Myrick Shinall

GeriPal - A Geriatrics and Palliative Medicine Podcast

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 and trials. Null trials like these often receive less attention in academic and clinical settings, but they can be profoundly practice-changing. Consider the . While some have argued it...

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The Future of Palliative Care? Community-Based Models with Alan Chiu, Mindy Stewart-Coffee, and Ben Thompson show art The Future of Palliative Care? Community-Based Models with Alan Chiu, Mindy Stewart-Coffee, and Ben Thompson

GeriPal - A Geriatrics and Palliative Medicine Podcast

“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 perspective shifting on this quote. Perhaps the advice given for a...

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Uncertainty In Medicine: Jonathan Ilgen and Gurpreet Dhaliwal show art Uncertainty In Medicine: Jonathan Ilgen and Gurpreet Dhaliwal

GeriPal - A Geriatrics and Palliative Medicine Podcast

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, “.” Together, we explore the nature of uncertainty in clinical practice, its effects on trainees and seasoned clinicians, and strategies...

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Why We Need QI Collaboratives: Guests Steve Pantilat, David Currow, and Arif Kamal show art Why We Need QI Collaboratives: Guests Steve Pantilat, David Currow, and Arif Kamal

GeriPal - A Geriatrics and Palliative Medicine Podcast

In a recent episode of the GeriPal podcast, we explored —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 experience as pioneers in developing QI collaboratives and registries. Together, they authored a recent paper in JPSM titled “,” which...

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Is Attending to Clinician Distress Our Job? Sara Johnson, Yael Schenker, & Anne Kelly show art Is Attending to Clinician Distress Our Job? Sara Johnson, Yael Schenker, & Anne Kelly

GeriPal - A Geriatrics and Palliative Medicine Podcast

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, including: A recent paper first authored by Yael asking if attending to clinician...

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Rehab and Death in Skilled Nursing Facilities: Sarguni Singh, Christian Furman, and Lynn Flint show art Rehab and Death in Skilled Nursing Facilities: Sarguni Singh, Christian Furman, and Lynn Flint

GeriPal - A Geriatrics and Palliative Medicine Podcast

In this week's podcast, we sit down with Drs. Sarguni Singh, Christian Furman, and Lynn Flint, three authors of the recent   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 often result in burdensome hospitalizations and goal-discordant care.  The discussion highlights key barriers in Medicare’s SNF and hospice benefits, including the inability to access concurrent hospice and SNF care, and explores...

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Inflammaging: Brian Andonian, Sara LaHue, Joe Hippensteel show art Inflammaging: Brian Andonian, Sara LaHue, Joe Hippensteel

GeriPal - A Geriatrics and Palliative Medicine Podcast

Six years ago we had John Newman on GeriPal to talk about (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 about one of the key pillars of Geroscience: inflammaging.  We use this terrific paper they...

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The Chaplain and the Doctor: A Podcast with Betty Clark and Jessica Zitter show art 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 show art 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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More Episodes

What’s the ideal blood pressure target for older adults with hypertension? Should we aim for a systolic BP of 120 mmHg in all older adults, as suggested by the SPRINT trial? Or should we be more flexible—especially for those who are frail or among the oldest old?

This week on the GeriPal Podcast, we explore the nuances of managing blood pressure in older adults with our guests Dr. Mark Supiano, Dr. Mitra Jamshidian, and Dr. Simon Ascher. 

Now, some of our astute GeriPal listeners may say, “wait, didn't you already talk about this with Mark Supiano in a 2017 podcast titled How Low Should We Go with Blood Pressure in Older Adults?”  Yes, we sure did, but we decided to revisit this topic as Mitra Jamshidian and Simon Ascher published a new JAGS research study focused on developing a framework to individualize the net benefit of intensive blood pressure control based on the results of the SPRINT trial.  Their key finding: most community-dwelling older adults in the SPRINT trial experienced greater benefits than harms from more aggressive blood pressure targets—even those who were older, frail, or on multiple medications.

Join us for an in-depth discussion on balancing risks, benefits, and patient preferences in hypertension management for older adults. Plus, we might just sneak in a little Frank Sinatra for good measure.