Primary Palliative Care for Cancer: Podcast with Yael Schenker and Bob Arnold

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GeriPal - A Geriatrics and Palliative Medicine Podcast 46 min 4 speakers 8 chapters transcribed 7 hours ago
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What is the main topic discussed in this episode?

Eric Widera 0:01
The JerryPow podcast is brought to you by Artstone Foundation, improving the health and well-being of older Californians and their caregivers. Welcome to the Jerry Pell Podcast. This is Eric Radera. This is Alex Smith. Thanks for joining me, Alex. Who else do we have?
Yeah.
Alex Smith 0:23
Right, so who do we have? Um, we have Yale Schenker, who is a professor of medicine and a palliative care doctor and director of the Palliative Care Research Center at the University of Pittsburgh. Uh she's on Twitter at Shinker Yale and it's all uh the Palliative Care Research Center is on Twitter at at palliative care. No, at Pit Palliative Care. I'll get this right. Welcome to
Unknown 0:47
We'll put it in the show notes. Thank you. Thank you for having me.
Eric Widera 0:52
That was my line
Alex Smith 0:53
yell.
Unknown 0:56
All right.
Alex Smith 0:58
We have Bob Arnold, who is a distinguished and this is where I can't read my notes, some sort of distinguished professor. Fill in the very distinguished professor. Distinguished professor at the University of Pittsburgh. Um, this being on the JerryPel podcast is on his bucket list. It's one of two items, and the other is being on fresh air. So I'm glad that we uh we accomplished one of his two bucket list items. He's on Twitter at at rubob r a b-o-b. Um, welcome to the JerryPel podcast, Bob.
Bob Arnold 1:31
Thanks for having me.
Eric Widera 1:34
Uh, I am excited uh about today's podcast because it was actually one of the medical students on our service, Kyle Hunter, actually brought up this trial, Connect, as a teaching point for our service. Connect was the title was published in JAMIM, Effect of an Oncology Nurse Led Primary Care Palet Palliative Care Intervention on Patients with Advanced Cancer. So we're gonna be talking all about primary palliative care and this trial, but before we do. Yale, I think you got a song request for Alex.

What is the main focus of the Connect trial and why was it created?

Unknown 2:03
I do. I would love to hear Bridge Over Troubled Water by Simon Garfunkel.
Alex Smith 2:07
And why?
Unknown 2:10
So it's one of my favorite songs. I grew up listening to a lot of Simon and Garfunkel. Um I think it's a nice metaphor for what we do in palliative care.
Alex Smith 2:18
Yeah, sure is. Love this song. Had to take it down a little bit.
Unknown 2:23
When you're weary Feeling small. When tears are in your eyes, I will drive them on. I'm on your side. Oh when times get rough And friends just can be found like a bridge of a troubled water. I will lay me down like a bridge over troubled water. I will lay me down.
Eric Widera 3:28
Woohoo! Thank you, Alex. Well, let's jump right into the topic. Primary palliative care. Yeah, what the heck is primary palliative care? How does it differ from specialty palliative care?
Unknown 3:43
So that is a really good question. Primary palliative care is traditionally defined as the basics of palliative care provided by the primary team taking care. Of the person with serious illness. So specialty palliative care involves specially trained clinicians. Primary palliative care is the basics of palliative care provided by the primary team.
Eric Widera 4:10
Um and Bob, what's the rationale behind it? Why why why do primary palliative care?
Bob Arnold 4:18
Because if palliative care doctors see ten percent. Of everybody in the country, that means 90% of the people who have serious illness who are dying are going to be cared for by their primary doctors. So if 10% get an A and 90% get a C minus, the grade for from a population basis is still a C minus.
Alex Smith 4:43
One never knows if Bob is joking or being serious, by the way.
Bob Arnold 4:48
No, I'm
Eric Widera 4:48
being serious. Um so I got a question. So okay, so that there is the access issue. But let's say we have randomized controlled trials of outpatient palliative care, specialty level palliative care, Jennifer Tomel study, lung cancer, follow-up study, and lung and colon cancer that have showed great positive outcomes. If it was a palliative care a map, if it was a drug, it would be standard of care. Should this be the same thing?

How do the hosts define primary palliative care and how does it differ from specialty palliative care?

Eric Widera 5:21
Should we even be thinking about priority? primary palliative care or should we just be increasing access to specialty palliative care?
Unknown 5:28
So um You know My sort of confession on the Jerry Powell podcast is that um I'm a primary care doc at heart. Um uh and ever since having the privilege of joining uh palliative care as a specialty and as a field, have really been sort of thinking about this question of when do we really need a specialist?

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