Why you should care about the shakeup at NIH: Sean Morrison, Ken Covinsky, Stacy Fischer
GeriPal - A Geriatrics and Palliative Medicine Podcast
Release Date: 06/18/2026
GeriPal - A Geriatrics and Palliative Medicine Podcast
The longevity industry is booming. Influencers are promoting this and that as promoting healthy aging, longevity, and healthspan, and it’s hard for us, much less our patients, to make sense of it. To be sure, we should always start by recommending exercise, nutritious foods, good sleep habits, and meaningful social interaction. We wanted to go beyond that to talk about the promise and potential and risks/harms of “biohacks.” Today we talk with Mahtab Jafari, PharmD, and John Newman, MD, PhD, and to discuss: How we clinicians should think about this movement, knowing many of...
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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 We’ve invited three of the trial's authors, , , and , to discuss this cluster-randomized clinical trial spanning 19 U.S. medical centers. We’ll discuss: Why was this trial done? Do we really need to run a separate palliative care trial for every single organ disease? What kind of specialized palliative...
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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 at the would affect a huge range of government grants, from Headstart to Transportation to the National Science Foundation, as well as the National Institutes of Health (NIH), the subject of today’s podcast. You dear listeners should all care. You should care because you care for older adults, or you’re a researcher who studies palliative care, or you're a chaplain who visited with the family of...
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Today’s podcast is a natural follow up to our podcasts on and .Today we talk about a new study about how clinicians , 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 take alternative approaches, like not offering interventions, not mentioning interventions, or simply stating a plan to limit interventions? Turns out doctors are using these alternative approaches frequently. Our guests are Jason Batten, Liz Dzeng, and Teva Brender, all clinicians, all of...
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Today we revisit a topic we last discussed in a : 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 solutions into how we talk about mistreatment This is not rocket science. Studying elder mistreatment is much harder than rocket science. Highlighting the reasons they focus on elder mistreatment, including inspiring words for...
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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, The tone is bleak. John’s experience since Covid, as you’ll hear, is very positive. Many of the concerns he raised about isolation have been addressed. Second, we hear from Bill Applegate,...
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Our focus today is on the search for the geriatrician identity, a continuation of the conversation we started with Jerry Gurtwitz on the . Today’s conversation is prompted by multiple articles in JAGS: (1) an article with a title the same as this podcast; (2) an article by Helen Fernandez on “”, a new combined 4 year internal medicine residency and geriatrics fellowship track; and (3) an article by Mary Tinetti titled, “?” Of note, Mary’s article is a follow up to her 2017 in which she wrote: Those outside the field have difficulty understanding what geriatrics is and...
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I had the privilege of learning from fellow Lisa Harris about a term she termed, “.” 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 issues in the face of polarization was deemed dangerous and undermining to one side or another. “How could you?” For Lisa’s work in finding common ground and embracing nuance she was awarded the for forging...
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While we have previously discussed 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 this episode of the GeriPal Podcast, we step into a space in serious illness care that is often misunderstood, overlooked, or reduced to a simple "call the organ donation network" checklist item. Joining us are three experts to help us...
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In this episode of the GeriPal podcast, we dive into the fascinating world of geriatric dermatology, or “GeriDerm,” with two exceptional guests: and . 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, including whether we all need to use sun protection and moisturizers, and if so, which ones? Then we explore the lag time to benefit in dermatology by examining whether we need to treat every actinic keratosis and basal cell carcinoma aggressively, or whether...
info_outlineEmergency 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 of Health (NIH), the subject of today’s podcast.
You dear listeners should all care. You should care because you care for older adults, or you’re a researcher who studies palliative care, or you're a chaplain who visited with the family of a patient who died today. You should care because these rule changes are so sweeping that they would remove standard components of the scientific review process and instead put them in the hands of political appointees.
You should care because if rules like this were in place in the 1980s, we might not have developed treatments to stop the HIV/AIDS epidemic. You should care because if these rules go into effect we will not be able to work with researchers in other countries studying outbreaks of Ebola or Hauntavirus. You should care because these rules silence federal research into groups of people we care for daily.
And if you’re not a researcher, your voice is even more important here. As Sean says, researchers who protest these proposed rule changes might come across as self-serving. Clinicians who are not researchers - who can say that these rules will negatively impact the science that improves care of older adults living with chronic conditions and their families - your voices may resonate even more.
What can you do? Most of these rule changes are open for public comment here until July 13, 2026. Every comment will be read and requires a response. It’s ok to respond anonymously. Personalized stories matter more than form responses. Tips:
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1: Say (or just describe to keep anonymous) who you are and why you are qualified to comment. Telling the story of how patients and families you care for or study is enough. Get your partner and parents to respond too. Simply being a concerned citizen is perfectly fine.
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2: List the exact provision #s that concern you, and explain what they would do. You do not need to quote the rule directly. Just explain what you understand it to mean in plain terms.
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Political Appointees Take Control of Grant Awards (§200.205);
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Peer Review Is No Longer Binding (§200.205(d));
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Active Grants Can Be Terminated at Any Time, for Any Reason (§200.340);
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DEI, Gender Research, and Related Topics Banned as Grant Conditions (§200.300);
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Prohibition on International Scientific Collaboration (§200.220);
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Conference Attendance Now Requires Express Agency Pre-Approval (§200.432);
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Publication Costs and Open Access Fees Presumptively Unallowable (§200.461)
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3: Explain the concrete harm. What would happen to your patients and their families if this provision takes effect?
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4: Closing: State clearly what you want OMB to do. This can be as simple as: “I urge OMB to withdraw these specific provisions: §200.340, §200.202, §200.205.” or “I urge OMB not to finalize this rule.”
Submit your comment in opposition here: The deadline is July 13, 2026. You can also email your congressperson or senator.
Times they are a changin’.