POPULARITY
Categories
69 episodes with Palliative care
42 episodes with Palliative care
72 episodes with Palliative care
46 episodes with Palliative care
69 episodes with Palliative care
68 episodes with Palliative care
23 episodes with Palliative care
13 episodes with Palliative care
19 episodes with Palliative care
23 episodes with Palliative care
19 episodes with Palliative care
19 episodes with Palliative care
19 episodes with Palliative care
22 episodes with Palliative care
14 episodes with Palliative care
22 episodes with Palliative care
19 episodes with Palliative care
11 episodes with Palliative care
12 episodes with Palliative care
18 episodes with Palliative care
9 episodes with Palliative care
21 episodes with Palliative care
7 episodes with Palliative care
23 episodes with Palliative care
8 episodes with Palliative care
8 episodes with Palliative care
15 episodes with Palliative care
11 episodes with Palliative care
9 episodes with Palliative care
8 episodes with Palliative care
21 episodes with Palliative care
4 episodes with Palliative care
14 episodes with Palliative care
3 episodes with Palliative care
7 episodes with Palliative care
5 episodes with Palliative care
7 episodes with Palliative care
13 episodes with Palliative care
12 episodes with Palliative care
6 episodes with Palliative care
5 episodes with Palliative care
9 episodes with Palliative care
6 episodes with Palliative care
5 episodes with Palliative care
5 episodes with Palliative care
6 episodes with Palliative care
4 episodes with Palliative care
5 episodes with Palliative care
12 episodes with Palliative care
5 episodes with Palliative care
5 episodes with Palliative care
9 episodes with Palliative care
14 episodes with Palliative care
5 episodes with Palliative care
Vasanta Pundarika built her career inside healthcare investment banking before launching Lotuspring, an advisory firm focused on women's health and behavioral health. She spent nearly 20 years advising healthcare systems, treatment providers, and growth stage companies on mergers, financing, and operational strategy while watching the industry repeatedly misunderstand the people it claimed to serve.The conversation starts unexpectedly with anthropology, bread, and language. Vasanta explains how she spent years changing the pronunciation of her own name to make other people comfortable before eventually reclaiming it. That thread opens into a much larger discussion about adaptation, identity, and what institutions quietly train people to tolerate.From there, the discussion moves into behavioral health, women delaying care, and the invisible labor that healthcare business models routinely ignore. During COVID, Vasanta noticed men's behavioral health units refilled faster than women's units. The reason had nothing to do with demand. Women were still home managing caregiving responsibilities, children, aging parents, and households while their own mental health collapsed in the background.The episode examines what happens when healthcare companies become “snazzy big brands” before building real clinical substance underneath. Vasanta describes the tension between mission and margin inside healthcare startups, private equity backed care models, and behavioral health expansion. The conversation pushes on who benefits when healthcare scales aggressively, who absorbs the operational pressure, and how patient trust erodes long before executives notice it on a dashboard.They also discuss patient advocacy culture, anthropology as systems analysis, healthcare capitalism, prior authorization, investor language, and why some clinically excellent companies never survive long enough to scale.RELATED LINKSVasanta PundarikaLotuspringWomen's Health HorizonsSakhi for South Asian SurvivorsNACDPrinceton University Anthropology DepartmentFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Brad Power spent years advising major corporations on systems design, process engineering, and decision making before lymphoma shoved him into the patient side of American healthcare. Instead of accepting the experience at face value, he started reverse engineering the machinery around cancer itself. Brad is the founder of Cancer Patient Lab and Open Cancer AI, two projects built around a blunt reality most patients discover too late: the healthcare system rewards people who know how to navigate it. Everyone else risks getting steamrolled by information asymmetry, insurance barriers, administrative friction, and institutional incentives designed around efficiency instead of human survival.The conversation starts with Harvard Business Review and Tumblr blogs before moving directly into the darker architecture underneath modern cancer care. Power explains how hospitals optimize for throughput, how insurance companies reward operational consistency over personalized medicine, and why many patients quietly end up needing a crash course in oncology, reimbursement policy, and behavioral psychology while fighting for their lives.The discussion digs into CAR-T therapy, functional testing, AI assisted decision support, and the growing collision between personalized medicine and standardized care pathways. Power argues that engaged patients often get better outcomes because they learn how to push for off guideline treatments, contest denials, and ask smarter questions. The counterpoint lands hard: patients should never have needed to become experts in the first place.The episode also explores the cultural consequences of AI entering cancer care. OpenAI advertising, data privacy, trust erosion, pharmaceutical influence, and “agentic AI” all collide inside a healthcare economy already drowning in distrust. Power sees artificial intelligence as a force multiplier for patient literacy and access. The larger system still decides who gets approved, who gets delayed, and who gets left behind.By the end, the conversation lands exactly where modern healthcare keeps forcing people to land: survival increasingly depends on learning how the machine works before the machine works on you.RELATED LINKSBrad PowerCancer Patient LabOpen Cancer AIHarvard Business ReviewResearch to the PeopleCAR T Cell TherapyFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Eine 10 Meter grosse Nähmaschine der Firma Bernina ist im Moment an einer Hausmauer in der Stadt Zug zu sehen. Die Werbung wurde 1941 gemalt und verschwand sieben Jahre später in einem schmalen Zwischenraum, weil daneben ein Neubau entstand. Bald ereilt sie wieder dasselbe Schicksal. Weiter in der Sendung: · Die Kantone Uri und Schwyz verstärken ihre Zusammenarbeit im Bereich der Palliative Care. · In einem Bordell in Küssnacht im Kanton Schwyz kam es zu einem Todesfall, die Ermittlungen laufen. · Die Luzerner Polizei konnte zwei Motorradfahrer identifizieren, die im Mai 2025 mit massiv überhöhter Geschwindigkeit und ohne Kontrollschilder unterwegs gewesen sind.
Eine 10 Meter grosse Nähmaschine der Firma Bernina ist im Moment an einer Hausmauer in der Stadt Zug zu sehen. Die Werbung wurde 1941 gemalt und verschwand sieben Jahre später in einem schmalen Zwischenraum, weil daneben ein Neubau entstand. Bald ereilt sie wieder dasselbe Schicksal. Alle Themen der heutigen Sendung: - Crans-Montana erwartet trotz Brandkatastrophe eine stabile Saison. - Die Kantone Uri und Schwyz verstärken ihre Zusammenarbeit im Bereich der Palliative Care. - Die Kantonspolizei Aargau will mehr Luftunterstützung: Eine Drohnenflotte soll die Polizei unterstützen. - In Zug ist ein Werbebild aus den 1940ern zum Vorschein gekommen.
By the time the paper hit version 71, Dr. Nirosha Murugan had already done the hard part. The data were real. The experiment had worked. A team of researchers had used a wearable bioreactor to trigger limb regeneration in frogs, a result with obvious implications for regenerative medicine. But the science still wasn't getting over the line. The problem wasn't the work. It was the translation.On this episode of Standard Deviation, host Oliver Bogler talks with Dr. Nirosha Murugan, a biophysicist and Tier II Canada Research Chair in Tissue Biophysics at Wilfrid Laurier University, about what happens when a scientist working at the edges of quantum biology, bioelectricity, and tissue regeneration runs headfirst into the unwritten rules of academic publishing. Murugan's research asks biologists to think beyond molecules and chemistry alone, and to consider the physical signals, electromagnetic fields, and invisible forces that shape development and healing. It is ambitious science. It is also exactly the kind of work that can make gatekeepers nervous.Bogler follows Murugan through the less glamorous part of discovery: the hidden curriculum of getting a paper published, securing scientific credibility, and learning that data do not simply “speak for themselves.” Murugan describes how jargon buried the pitch of her own work, how a lack of editorial support left her at a disadvantage, and how the JEDI program at the Life Science Editors Foundation paired her with a former journal editor who taught her how to structure a manuscript, write a cover letter, and survive peer review.The result was publication in Science Advances, but the larger story is about power. Who gets taught the rules of biomedical research. Who has access to grant writers, editors, and institutional polish. Who is left to brute-force their way through the maze. And how one scientist, having finally found the map, now makes sure her own trainees do not have to learn it the hard way.RELATED LINKSDr. Nirosha MuruganWilfrid Laurier UniversityLife Science Editors FoundationJEDI ProgramScience Advances paper on limb regenerationFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Dr. Jess Peatross trained in conventional medicine and worked as a hospitalist before she started questioning why so many chronically ill patients kept getting worse inside the healthcare system she trusted. Her perspective carries weight because she spent years following every protocol exactly as taught before walking away from hospital medicine entirely.Raised in Huntington, West Virginia during the opioid crisis, she entered medicine believing the system existed to heal people. Instead, she found hospitals driven by billing codes, liability management, and pharmaceutical dependence while patients with chronic illness, autoimmune disease, mold exposure, and chronic pain cycled endlessly through appointments and prescriptions.Dr. Peatross explains what pushed her toward functional medicine, cannabis therapy, and prevention focused care after watching patients improve only after leaving conventional treatment pipelines behind. The conversation tackles physician burnout, chronic illness stigma, healthcare incentives, and the growing collapse of trust between patients and institutions.The discussion also moves into supplements, environmental toxins, ultra processed food, and the uncomfortable economics behind keeping people permanently sick but continuously billable. Dr. Peatross describes the professional backlash that comes with challenging medical orthodoxy while Matthew connects her experience to the broader erosion of public trust across American healthcare.Together they unpack what happens when patients stop believing the system can help them and start searching elsewhere for answers.RELATED LINKSDr. Jess PeatrossInstagramMarshall UniversityBrave New WeedFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
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 PAL-LIVER trial, published this year in JAMA Internal Medicine. We've invited three of the trial's authors, Manisha Verma, Chris Woodrell, and Marie Bakitas, 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 care training did the hepatologists receive? What exactly is meant by the finding that hepatologists were not statistically superior, but were shown to be statistically non-inferior? Lastly, we discuss whether these results change anyone's practice, and whether healthcare systems should decide which type of palliative care model to fund (primary vs. specialty.) —- References we discussed Developing palliative care interventions in liver disease using formative and summative qualitative evaluation. Hepatology 2026 Palliative Care for Advanced Liver Disease: Hepatology and Palliative Care Specialists Experiences. J Pain Symptom Manage 2026
Farla Efros is a senior retail executive and former CEO who built and sold companies before facing her own breast cancer diagnosis. She brings that same operational mindset into a healthcare system that expects patients to manage complexity while they are at their most vulnerable.She was on a client call in Spain when the diagnosis came through. A clear mammogram had missed it. An MRI caught it. Within hours, she was ordering binders, building a plan, and structuring her treatment like a turnaround strategy. Every appointment became a meeting. Every doctor faced an agenda with dozens of questions. She paid out of pocket for PET scans that were denied and hired a third party firm to validate her treatment path when her own doctors resisted outside input. The conversation tracks what happens when a high-functioning executive enters a system built on delay, denial, and fragmentation. Efros describes negotiating for tests, managing physician relationships, and assembling an “executive board” of advisors across conventional and alternative care. She calls the experience “the worst client I ever had,” exposing how administrative burden shifts onto patients and families.The tension sits between what worked for her and what is inaccessible to most. Her approach requires confidence, time, and fluency in navigating power. The system rewards that behavior while quietly failing patients who cannot replicate it. Insurance coverage still left her paying out of pocket. Doctors pushed standard protocols over precision medicine. Survivorship offered little support once treatment ended.This episode examines how cancer care operates as a series of incentives rather than a coordinated system, and why patients are forced to become operators just to get through it.RELATED LINKSFarla EfrosFarla Efros on LinkedInF*ck CancerF*ck Cancer on AmazonAccentureCTOAMPULL QUOTES“I treated cancer like the worst client I ever had.”“They wouldn't approve the test, so I paid for it myself.”“Every appointment was a negotiation.”FEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Ihre Arbeit veränderte den Umgang mit dem Tod grundlegend: Die Sterbeforscherin Elisabeth Kübler-Ross. Diese Tage hätte sie ihren 100. Geburtstag gefeiert. Und heute, in einer zunehmend alternden Gesellschaft, stellt sich dringlicher denn je die Frage: Wie werden wir in Zukunft sterben? Mit «Interviews mit Sterbenden» leistete die schweizerisch-US-amerikanische Psychiaterin und Sterbeforscherin Elisabeth Kübler-Ross 1969 Epochemachendes: Sie brach das Schweigen über den Tod und verschob ihn aus der Tabuzone in den gesellschaftlichen Diskurs. Ihre kulturelle Leistung liegt darin, das Sterben als Teil des Lebens sichtbar gemacht zu haben – eine Voraussetzung für die moderne Palliativmedizin. Gleichzeitig stellt die demografische Entwicklung diese Errungenschaften infrage. Immer mehr Menschen erreichen ein hohes Alter – häufig verbunden mit langen Phasen von Krankheit und Demenz. Der Palliativmediziner Gian Domenico Borasio spricht von einem «Tsunami von hochaltrigen Sterbenden», der auf uns zukomme und grundlegende Fragen nach Würde, Autonomie und Fürsorge neu aufwirft. Ein auf Effizienz getrimmtes Gesundheitssystem gelangt damit an seine Grenzen. Braucht es neue Formen der Solidarität, «Caring Communities», und eine stärkere Vergesellschaftung von Sorgearbeit? Welche Rolle kann Palliative Care als Modell für ein menschlicheres System spielen – und was heisst das für uns alle? Olivia Röllin fragt nach bei Gian Domenico Borasio, eine der prägenden Stimmen in der Debatte um ein würdiges Lebensende.
Ihre Arbeit veränderte den Umgang mit dem Tod grundlegend: Die Sterbeforscherin Elisabeth Kübler-Ross. Diese Tage hätte sie ihren 100. Geburtstag gefeiert. Und heute, in einer zunehmend alternden Gesellschaft, stellt sich dringlicher denn je die Frage: Wie werden wir in Zukunft sterben? Mit «Interviews mit Sterbenden» leistete die schweizerisch-US-amerikanische Psychiaterin und Sterbeforscherin Elisabeth Kübler-Ross 1969 Epochemachendes: Sie brach das Schweigen über den Tod und verschob ihn aus der Tabuzone in den gesellschaftlichen Diskurs. Ihre kulturelle Leistung liegt darin, das Sterben als Teil des Lebens sichtbar gemacht zu haben – eine Voraussetzung für die moderne Palliativmedizin. Gleichzeitig stellt die demografische Entwicklung diese Errungenschaften infrage. Immer mehr Menschen erreichen ein hohes Alter – häufig verbunden mit langen Phasen von Krankheit und Demenz. Der Palliativmediziner Gian Domenico Borasio spricht von einem «Tsunami von hochaltrigen Sterbenden», der auf uns zukomme und grundlegende Fragen nach Würde, Autonomie und Fürsorge neu aufwirft. Ein auf Effizienz getrimmtes Gesundheitssystem gelangt damit an seine Grenzen. Braucht es neue Formen der Solidarität, «Caring Communities», und eine stärkere Vergesellschaftung von Sorgearbeit? Welche Rolle kann Palliative Care als Modell für ein menschlicheres System spielen – und was heisst das für uns alle? Olivia Röllin fragt nach bei Gian Domenico Borasio, eine der prägenden Stimmen in der Debatte um ein würdiges Lebensende.
In 2020, Emily Mendenhall drove from Washington, DC to Okoboji, Iowa, a town of 800 that swells to 200,000 every summer, and walked into a pandemic that looked nothing like the one dominating national headlines. Inside gas stations and bars, masks marked you as an outsider. In one stop, a man told her family they would not be served if they kept theirs on. Her 6 year old daughter cried, confused. Mendenhall, a medical anthropologist at Georgetown University, did what she always does. She started asking questions. Over months, she interviewed neighbors, former classmates, and local officials, including her own brother in law who helped lead the local COVID response. The result became Unmasked, a case study in how community identity, economics, and politics shaped public health decisions in real time. That work led directly into her latest book, Invisible Illness: A History, from Hysteria to Long COVID, where she tracks a much older problem. Patients with chronic illness, especially women, often fail to meet medicine's demand for proof. Without a clear diagnosis, they lose access to care, insurance coverage, and legitimacy. Mendenhall argues that long COVID did not create this failure. It exposed it.This conversation centers on how healthcare systems reward certainty and punish complexity. Long COVID clinics send patients to 17 specialists without resolution. Insurance structures require diagnoses that many conditions cannot provide. Medical training still struggles to integrate trauma, mental health, and chronic disease into a coherent model of care.Mendenhall brings lived experience into the conversation. After COVID, she dealt with months of fatigue and escalating anxiety that altered her baseline health. She does not claim the label of long COVID, but she understands how quickly the system becomes harder to navigate once symptoms stop fitting clean categories. The stakes are not theoretical. In the United States, access to healthcare, disability benefits, and treatment still depends on whether a condition can be measured, coded, and reimbursed. For millions living with invisible illness, the burden of proof becomes the illness itself.RELATED LINKSEmily MendenhallInvisible Illness: A History, from Hysteria to Long COVIDScience PoliticsGeorgetown UniversityFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
What if the patient never noticed the merger at all? For Matt Staub, that's not a failure — it's the goal. In this episode, Your Health CEO Matt Staub sits down with Jamie to talk through the company's merger with TCPA and Providence Care — a move that brings together similar footprints in primary care, palliative, hospice, skilled nursing, and assisted living across South Carolina and Georgia. As a 23-year healthcare veteran going through his first merger, Matt is candid about the tedious due-diligence "earnest money" phase, the EMR transitions ahead, and why he refuses to let "what could go wrong" crowd out "what could go right." You'll hear: Why "mass moves mass" — and what scale actually buys patients in care management and data analytics How Your Health breaks 50,000 patients into groups, teams, and "hubs" so no one falls through the cracks The "change is hard" philosophy and the discipline of productive (not just effective) communication How the spirit of agape — godly love — still threads through a company that's evolved far past its original name What success looks like in six months: patient retention, mission and margin If you lead through change — or live through it — this one will reframe how you think about getting bigger without losing what made you matter.
Die Swakopmund Sages Senior Gholfspelersvereniging het onlangs kombuistoerusting ter waarde van 20 000 Namibiese dollar aan die nuutgestigte Palliative Care Namibia Erongo-sentrum geborg. Die skenkings is die opbrengs van die Sages Gholfspelers-toernooie wat deur die jaar by die Rossmund-gholfbaan in Swakopmund aangebied word. Sanet de Waal, hoof van die Kankervereniging van Namibië se Erongo-sentrum:
Join me, Savy for Episode 3 of Season 18, with Dan Haire of Navian Hawaii, Catia Garell of Thrive for Life and World-Renowned Laughter Leader and Award-Winning Empowerment Coach Bianca Spears returns for our Mindful Moment! We're here to bring back the joy of Caregiving, we're here to connect you to the resources that you need, because you DESERVE some "CARING"From this Episode:Havian Hawaii - Guiding and assisting patients and their families through difficult times, providing Palliative Care to patients battling serious illnesses or delivering Hospice Care to patients nearing their end-of-life journeyThrive for Life - The only known premier residential accessibility consulting firm in Hawai'iBianca Spears - World-Renowned Laughter Leader and Award-Winning Empowerment Coach: Showing others how to activate more fun, freedom & flow in their livesOur Resources:Gimme A Break - Non-profit for caregivers aiming to bring back joy to caregiving, free weekly support sessions offering caregivers a chance to relax, renew, resource and revive. Register or register a caregiver for a break.Givers Guides Magazine - The complete caregiver resource guide. Get your first issue today, as 100% of all profits are donated to support Gimme A Break.Your Host:Savy Makalena - founder of Gimme a Break and Givers Guides Connect with the Caring Caregiver Show:Facebook Page: Caring Caregiver ShowInstagram: caringcaregivershowWebsite: www.caringcaregivershow.comFacebook Group: Click here to join
Fouzia and Kashaf want their father to live with dignity and less suffering following a devastating life-limiting diagnosis, and found it through Dr. Paul Coulter, who heads up the palliative care service at NMC Healthcare in Dubai.See omnystudio.com/listener for privacy information.
At 25, Jace Yawnick was building a career in health and wellness sales, chasing growth, status, and the usual young adult fantasy of getting somewhere fast. Then his body stopped cooperating. Fatigue turned into chemotherapy. The diagnosis was primary mediastinal B cell non Hodgkin lymphoma, and the rest of his life split into before and after. Now in remission, he talks about cancer the way people actually live it, not the way nonprofits package it. He gets into survivorship, mental health, young adult isolation, and the deadening absurdity of prior authorization. One of the sharpest parts of the conversation lands on a simple American insult disguised as policy: treatment innovation means very little when insurance can still deny the scan, the drug, or the next step. Jace has seen that firsthand, including during routine monitoring after active treatment. This episode tracks what happens when a young cancer patient becomes a public voice and refuses to play mascot. It covers oncology, insurance, remission, advocacy, and the long mental hangover that follows survival. It also names the part too many institutions dodge: the system works great right up until it doesn't, and when it fails, patients get handed the bill, the panic, and a camera if they want anyone to care. RELATED LINKSJace Beats CancerJace Yawnick on LinkedImConquer Cancer ArticleCURE Today ArticlePyure BrandsFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
What if the most important care in the entire healthcare system is also the most underfunded? While hospitals and inpatient reimbursements rise with inflation, the physician fee schedule has quietly declined roughly 33% in real terms over 25 years — and this year it's facing another cut. In this episode, Jamie Preston sits down with Your Health CEO Matt Staub, just back from Capitol Hill, where he spent a record-setting 95-degree day meeting with seven legislative offices to advocate for physicians, providers, and the patients they serve across rural South Carolina, Georgia, and beyond. What follows is part field report, part reflection on why preventive primary care saves money and lives — and why we plan meticulously for weddings, retirement, and vacations, but treat our own health with a "call us if something happens" approach. In this conversation: Why a 2.5–5% physician fee cut hits frontline rural practices hardest The bipartisan doctors' caucus and the real appetite for reform Why winning can come from a loss — the Kobe Bryant mindset on process over outcome How a Disney ride (Spaceship Earth) reframes humanity's whole story around communication The case for proactive, team-based primary care over reactive sick visits Press play for a conversation about advocacy, communication, and a simple, powerful idea: the change you need to make starts with you.
What if educating your people so well that they could leave was exactly the point? At Your Health, that's not a risk to manage — it's the philosophy that built an entire learning ecosystem. In this episode, Jamie talks with Aubrey Wall, who came to Your Health from a background in education and now leads Your Health University, the organization's learning management system and continuous-development engine. Aubrey brings an educator's eye to a fast-evolving healthcare environment, where best practice changes by the day and meeting patients where they are demands that staff never stop learning. Here's what you'll hear: Why a healthcare company runs 12-month, Department of Labor–registered apprenticeships — including programs in management, value-based care, population health, and hospice aide preparation How gamification is being built into nurse instruction (straight from Aubrey's dissertation research) The difference between Your Health University (your classroom) and the Hub (your resource library) How LinkedIn Learning delivered roughly $4.2 million in CEUs to staff last year Meeting Leah — the new AI assistant that helps employees find exactly the right course If you've ever believed growing your people is a cost rather than the whole point, this conversation will change how you think. Press play, then go ask Leah a question. www.YourHealth.Org
Dale Atkinson Description In 2024, Dale Atkinson was diagnosed with Stage IV esophageal cancer. His diagnosis preceded by the death of his mother and was preceded by his partner being diagnosed with lung cancer. All this in the space of a few weeks. Dale was active in sports and consumed a healthy diet, but in 2019 began to suffer chronic acid reflux. His symptoms were repeatedly treated as acid reflux, but it wasn't until 2024 that he underwent an endoscopy, which immediately revealed a tumor and a diagnosis of Stage IV esophageal cancer. Dale was told he didn't have long to live and was immediately placed in palliative care. However, he did extensive research and essentially designed his own care plan, combining conventional chemotherapy and immunotherapy with non-mainstream remedies. In 2025, the tumor shrank and he was declared to have No Evidence of Disease. In 2019, Dale Atkinson was still in his twenties, was on a vegetarian diet and was active in four sports, including rugby. Then he began to experience chronic acid reflux and heartburn. Sleep was interrupted by rising into his throat. He had difficulty swallowing. Dale sought medical attention, but his symptoms were repeatedly treated as reflux. In 2024, Dale was scheduled for an endoscopy. Because his partner had just been diagnosed with lung cancer, she could not drive, and because of that, Dale was not anesthetized for the procedure. As a result, along with his care team, he viewed the endoscopy, which showed a 9.2cm tumor and with it a diagnosis of Stage IV esophageal cancer. Doctors told Dale he did not have long to live and that his only treatment option was palliative care. He was diagnosed on October 12, 2024. Nine days earlier, his partner was diagnosed with lung cancer and on October 27, his mother passed away. Overwhelmed with devastating news, once it all sunk in, Dale decided he would let determination spearhead his journey, determination and not fear. His palliative care regimen was supposed to consist of chemotherapy and immunotherapy, but Dale said he approximately 5,000 research paper, concluded which non-traditional therapies could be of help and asked that his regimen include a combination of the non-mainstream medications along with chemotherapy and immunotherapy. He learned in January 2025 his tumor decreased in size, he was able to swallow normally and could go hours at a time without any pain. He was declared No Evidence of Disease, and thought things were getting back to normal. He got off his protocol, but in March, cancer symptoms returned. Dale got back on his protocol, and months later, again was declared NED. He still suffers from chemo-related brain fog but enjoys life with his partner and two young sons. Additional Resources: Dale's charity: "Beyond the Standard." Dale's blog: https://www.thelifeorganic.com Dale's fitness center: https://www.peakhealthandfitness.co.uk
At 20 years old, newly arrived from Puerto Rico and trying to build a future in science, Benjamin Suarez Jimenez found himself sitting in front of two senior faculty members accused of plagiarism. He knew the material. He had done the work. His mistake came from failing to cite class notes during an exam because nobody had told him that was expected. In a matter of minutes, he watched what felt like his entire career flash before him.On this episode of Standard Deviation, host Oliver Bogler examines the hidden architecture of academic science through the experiences of Dr. Benjamin Suarez Jimenez, Assistant Professor at the University of Rochester and a neuroscientist studying PTSD, anxiety, trauma, and spatial cognition through virtual reality and video game environments.Benjamin traces his path from Puerto Rico to the mainland United States, through the NIH, Columbia University, and eventually to leading his own laboratory. Along the way, he encountered a series of barriers that had little to do with scientific ability and everything to do with access to unwritten rules. From academic gatekeeping to grant writing expectations, he learned that success in biomedical research often depends on knowledge that never appears in a textbook.Oliver explores how those invisible obstacles shape careers, influence research funding, and determine who gains access to opportunity. The conversation also examines the Justice, Equity, Diversity, and Inclusion Program at the Life Science Editors Foundation, which pairs scientists from underrepresented backgrounds with experienced scientific editors. Through that mentorship, Benjamin transformed a critical grant proposal into a successful pilot award that helped launch an NIH R01 application.The discussion extends beyond one scientist's experience. Benjamin describes helping a former mentee navigate dissertation roadblocks that threatened her graduation, illustrating how institutional bureaucracy can delay careers and discourage talented researchers. Together, they explore the hidden administrative burden, cultural barriers, and bias that many scientists carry alongside their research, and what happens when someone who receives support turns around and opens the door for others.RELATED LINKSLife Science Editors FoundationBenjamin Suarez Jimenez LabDr. Benjamin Suarez JimenezBenjamin Suarez JimenezFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Dr. Sarah Matt trained as a burn surgeon, working in a field where patients arrive with catastrophic injuries and survival depends on speed, skill, and resources. She left the bedside after confronting a limit that medicine does not like to admit. One physician can only see so many people in a day. The system surrounding those patients decides the rest. She moved into health technology, held leadership roles in startups, and built global infrastructure at Oracle to scale care across populations. Then she watched billions of dollars in digital health and AI initiatives stall out when they hit real clinical environments.This episode follows that pivot from surgeon to strategist and back into direct patient care in rural New York, where she now treats uninsured patients, migrant workers, and communities pushed to the margins. The conversation centers on a persistent failure across healthcare systems. Products get built for regulators, executives, and investors instead of the people who use them. The result shows up in failed adoption, broken workflows, prior authorization delays, and rising physician burnout.The discussion cuts through health policy language and lands on lived consequence. The system rewards speed over usability, scale over trust, and compliance over care. Patients absorb the fallout. Physicians carry the liability. The incentives remain intact.RELATED LINKSDr. Sarah MattThe Borderless Healthcare RevolutionThe Clinical RealistJessica FedererSovatoFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
In this powerful episode of Diary of a Kidney Warrior Podcast, host Dee Moore is joined by Rebecca Griffiths, who shares her extraordinary journey through kidney failure, dialysis, kidney transplantation and transplant loss. Rebecca's story is one of resilience, determination and hope. After gaining approximately 25kg of fluid in a matter of days and requiring emergency treatment to drain fluid from around her heart, she found herself facing kidney failure without the support of a renal team. What followed was a life-changing journey that included dialysis, a kidney transplant, the devastating loss of that transplant and the challenge of starting again. In this episode, Rebecca discusses:
This is another insightful episode of AGEING GRACEFULLY, where we delve into the intersection of faith and critical topics affecting the evening of our lives. In this episode, we're shining a compassionate light on Palliative Care through the lens of our Catholic faith. Join us as we navigate the complex and sensitive landscape of end-of-life care, seeking professional and spiritual insights and guidance.Special guests, Dr. Carolin Elizabeth, and Dr. John Tharakan who are experts in the field of Palliative Care and devoted Catholics along with Fr. Juventius Andrade, will share their knowledge and experiences, offering a unique perspective on finding solace and meaning during challenging times. Join the discussion that illuminates the path of compassionate care and how faith plays a crucial role in providing comfort to those in need.Whether you are a caregiver, a healthcare professional, or someone navigating the complexities of serious illness, this episode aims to provide solace, understanding, and a sense of purpose through open discussions and dialogue. Topics Covered:The Catholic approach to end-of-life careFinding spiritual meaning in sufferingNavigating ethical dilemmas in Palliative CareSupport for caregivers and families
This insightful episode of AGEING GRACEFULLY delves into the intersection of faith and critical topics affecting the evening of our lives. In this episode, we're shining a compassionate light on Palliative Care through the lens of our Catholic faith. Tune in as we navigate the complex and sensitive landscape of end-of-life care, seeking professional and spiritual insights and guidance.Special guests, Dr. Carolin Elizabeth, and Dr. John Tharakan who are experts in the field of Palliative Care and devoted Catholics along with Fr. Juventius Andrade share their knowledge and experiences, offering a unique perspective on finding solace and meaning during challenging times. This discussion illuminates the path of compassionate care and how faith plays a crucial role in providing comfort to those in need.Whether you are a caregiver, a healthcare professional, or someone navigating the complexities of serious illness, this episode aims to provide solace, understanding, and a sense of purpose through open discussions and dialogue.Topics Covered:The Catholic approach to end-of-life careFinding spiritual meaning in sufferingNavigating ethical dilemmas in Palliative CareSupport for caregivers and families
Special guests, Dr. Carolin Elizabeth, and Dr. John Tharakan who are experts in the field of Palliative Care and devoted Catholics along with Fr. Juventius Andrade, share their knowledge and experiences, offering a unique perspective on finding solace and meaning during challenging times. The discussion illuminates the path of compassionate care and how faith plays a crucial role in providing comfort to those in need.Whether you are a caregiver, a healthcare professional, or someone navigating the complexities of serious illness, this episode aims to provide solace, understanding, and a sense of purpose through open discussions and dialogue.Topics Covered:The Catholic approach to end-of-life careFinding spiritual meaning in sufferingNavigating ethical dilemmas in Palliative CareSupport for caregivers and families
Your guide to a kinder end-of-life journey in the ICU. Synopsis: Every first Wednesday of the month, The Straits Times helps you make sense of health matters that affect you. Tan Tock Seng Hospital and National University Hospital recently launched a new initiative called A Kinder ICU that is supported by a 3.93 million grant from the Lien Foundation. The aim is to integrate palliative care into standard ICU treatment. In this episode, Joyce Teo finds out more about the initiative and the nature of palliative care from her two guests. They discuss how palliative care has evolved and how it provides essential support to patients who are critically ill and their families. The conversation also explores the importance of reflecting on the desired quality of life as one approaches the end of their journey. The two guests are Assistant Professor Neo Han Yee, a senior consultant and head of the palliative medicine department at Tan Tock Seng Hospital, and Ms Charmaine Sim, an advanced practice nurse at the medical intensive care unit at the National University Hospital. Highlights (click/tap above): 2:26 Palliative care 10-20 years ago vs now 5:28 Feeling conflicted seeing a family member in the ICU 9:27 There is an art to palliative care 10:23 Life presents you with unexpected crises 14:10 Medical staff will also feel distressed if they are imposing pain on patients 21:12 Helping the family of a man who fell critically ill just before he was about to return home 23:40 Is it fair to keep trying to save his life? 25:03 The doctor is legally authorised to withdraw life support when life-sustaining efforts are futile, but there’s a need to help the family hold that grief 29:30 Filial piety is a virtue but it can also create a sense of guilt 34:26 What is the minimum quality of life you want to live by? 35:43 You cannot assume that you will pass away in your sleep… Read Joyce Teo's stories: https://str.sg/JbxN Host: Joyce Teo (joyceteo@sph.com.sg) Produced and edited by: Amirul Karim Executive producers: Ernest Luis and Lynda Hong Follow Health Check Podcast here and get notified for new episode drops: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ Feedback to: podcast@sph.com.sg --- Follow more ST podcast channels: All-in-one ST Podcasts channel: https://str.sg/wvz7 Get more updates: http://str.sg/stpodcasts The Usual Place Podcast YouTube: https://str.sg/theusualplacepodcast --- Get The Straits Times app, which has a dedicated podcast player section: The App Store: https://str.sg/icyB Google Play: https://str.sg/icyX --- #healthcheckSee omnystudio.com/listener for privacy information.
Your guide to a kinder end-of-life journey in the ICU. Synopsis: Every first Wednesday of the month, The Straits Times helps you make sense of health matters that affect you. Tan Tock Seng Hospital and National University Hospital recently launched a new initiative called A Kinder ICU that is supported by a 3.93 million grant from the Lien Foundation. The aim is to integrate palliative care into standard ICU treatment. In this episode, Joyce Teo finds out more about the initiative and the nature of palliative care from her two guests. They discuss how palliative care has evolved and how it provides essential support to patients who are critically ill and their families. The conversation also explores the importance of reflecting on the desired quality of life as one approaches the end of their journey. The two guests are Assistant Professor Neo Han Yee, a senior consultant and head of the palliative medicine department at Tan Tock Seng Hospital, and Ms Charmaine Sim, an advanced practice nurse at the medical intensive care unit at the National University Hospital. Highlights (click/tap above): 2:26 Palliative care 10-20 years ago vs now 5:28 Feeling conflicted seeing a family member in the ICU 9:27 There is an art to palliative care 10:23 Life presents you with unexpected crises 14:10 Medical staff will also feel distressed if they are imposing pain on patients 21:12 Helping the family of a man who fell critically ill just before he was about to return home 23:40 Is it fair to keep trying to save his life? 25:03 The doctor is legally authorised to withdraw life support when life-sustaining efforts are futile, but there’s a need to help the family hold that grief 29:30 Filial piety is a virtue but it can also create a sense of guilt 34:26 What is the minimum quality of life you want to live by? 35:43 You cannot assume that you will pass away in your sleep… Read Joyce Teo's stories: https://str.sg/JbxN Host: Joyce Teo (joyceteo@sph.com.sg) Produced and edited by: Amirul Karim Executive producers: Ernest Luis and Lynda Hong Follow Health Check Podcast here and get notified for new episode drops: Channel: https://str.sg/JWaN Apple Podcasts: https://str.sg/JWRX Spotify: https://str.sg/JWaQ Feedback to: podcast@sph.com.sg --- Follow more ST podcast channels: All-in-one ST Podcasts channel: https://str.sg/wvz7 Get more updates: http://str.sg/stpodcasts The Usual Place Podcast YouTube: https://str.sg/theusualplacepodcast --- Get The Straits Times app, which has a dedicated podcast player section: The App Store: https://str.sg/icyB Google Play: https://str.sg/icyX --- #healthcheckSee omnystudio.com/listener for privacy information.
In the late 1980s, a child exposed to fallout from the Chernobyl disaster lay in a hospital bed while doctors told his family there were no clear answers and no reliable path forward. Decades later, that same child, Yan Leyfman, walks into exam rooms as a hematology oncology fellow, expected to deliver clarity inside a system that still runs on delay, uncertainty, and institutional self preservation.This episode traces the throughline from early life shaped by radiation exposure and hospice level uncertainty to a career inside academic medicine, translational research, and oncology media. Yan built his identity around survival and usefulness, moving from patient to physician while carrying the memory of what it feels like to sit on the other side of the table. He helped launch MedNews Week during the COVID crisis to push back on misinformation and expand access to medical knowledge, stepping into a public role while still in training.The conversation stays grounded in the friction between personal narrative and system reality. Clinical training demands efficiency, hierarchy, and emotional distance. Cancer care demands time, clarity, and human connection. Those forces collide in real patient encounters where prior authorization delays, insurance barriers, and fragmented care pathways shape outcomes as much as any treatment protocol.Yan speaks openly about mentorship, belonging, and the drive to make meaning out of survival. The discussion pushes further into what the healthcare system actually rewards, what it quietly strips away, and how quickly empathy can erode under institutional pressure. The episode also examines the role of medical media, where education, industry influence, and narrative control often blur together.This is a conversation about identity under construction, about what happens when someone who remembers powerlessness steps into a role that carries authority, and about whether that memory can survive long enough to change anything.RELATED LINKSYan Leyfman on LinkedInYan Leyfman on InstagramSurviving ChernobylFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Send us Fan MailWhen someone receives a life altering diagnosis or is living with a chronic condition, patients need additional medical, spiritual and emotional support to live well through their diagnosis. Learn how each member of the palliative care team can support the patient while providing comfort to those providing care. Support the showSeniorSupportStrategies.com when you need guidance navigating senior care or how to create your own Aging in Place strategy.
Confronting the death of a loved one – or the end of our own life – can be frightening and overwhelming. And yet it is something that will happen to all of us. So how can we open up conversations about the way we want to die? Is it possible to avoid pain and suffering? And who are the people who will care for us in our final moments?Datshiane Navanayagam talks to two women who work in palliative care.Dr Tania Pastrana is from Colombia and is now based in Germany where she works for the International Association for Hospice & Palliative Care (IAHPC). And Dr Catherine Millington-Sanders is a general practitioner, and national lead in palliative care for the Royal College of GPs.Producer: Hannah Sander
In this raw and unflinching episode of the Prolonged Field Care Podcast, Dennis sits down with Thad Snyder (physician, former medic, and brigade surgeon) to tackle one of the most uncomfortable topics in combat medicine: what happens when resources run out, evacuation timelines collapse, and “doing everything” is no longer possible.Drawing from a 72-page crisis standards of care memo (originally written for flu and updated for COVID), Thad explains the shift from standard → contingency → crisis care, the ethical duty to plan for no-win scenarios, and why medics, teams, and leaders must have real conversations about capabilities, limitations, and what “living” actually means after catastrophic injury. They explore palliative/comfort care in austere environments, the emotional weight of those decisions, and practical ways to share the burden so the medic isn't left carrying it alone.Essential listening for medics, operators, team leaders, and anyone preparing for large-scale combat or prolonged operations where the next casualty might not get a bird out for days or weeks.Key TakeawaysThere is a duty to plan for crisis standards of care before you're in the middle of it.Leaders and teams must understand the real capabilities and limitations of their medics—not the 437-task training list.Pre-mission conversations about quality of life, advanced directives, and unacceptable outcomes give medics a moral framework when they have to make the hardest calls.Palliative/comfort care is already happening in modern conflicts (Ukraine, etc.) even if no one wants to talk about it.The emotional and moral burden of end-of-life decisions cannot fall solely on the medic—teams and leaders must share ownership.Staying busy to “do something” can sometimes cause more harm than shifting to dignity-focused comfort care.Chapters00:00 – Intro & Pulling the Crisis Standards Memo from the Closet00:56 – Standard, Contingency, and Crisis Care: What Changes When Resources Vanish02:51 – The Duty to Plan: Preparing for No-Win Scenarios04:55 – Why Commanders Need Brutally Honest Briefs on Medic Capabilities06:20 – Surgical Team Limitations, Non-Survivable Injuries, and Realistic Expectations08:40 – Advanced Directives, Quality of Life, and “Living vs. Being Alive”11:36 – Palliative Care in Large-Scale Combat (Ukraine, Future Conflicts)13:15 – How (and When) to Have These Conversations with Your Team14:38 – The Emotional Reality: Holding Someone's Hand While They Die Is Harder Than Any Procedure20:33 – Real Hospital Examples of Hard End-of-Life Discussions25:58 – What Outcomes Actually Matter to Warriors? (Walking, talking, independence)32:00 – Using Patient Values as a Moral Framework in Crisis35:04 – Offloading the Burden: Team Ownership of Comfort Care Decisions40:43 – Shared Responsibility, Rituals, and Preventing Moral Injury43:14 – Final Thoughts + Where to Get the Crisis Standards DocumentThis episode is heavy, honest, and desperately needed. Share it with your team.For more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
188 The Intersection of Hospice and Palliative Care: A Conversation with Dr. Jill Schwartz-Chevlin, MD, MBA, FACP Host Marie Betcher, RN and former hospice nurse, interviews Dr. Jill Schwartz-Chevlin, an internist and palliative physician with experience in home-based primary care, hospice leadership, and value-based care. Dr. Jill explains value-based medicine as aligning incentives with patient outcomes, especially for people with complex chronic illness, by anticipating needs, supporting symptom recognition, and preventing crisis-driven ER and hospital use that can lead to debility and loss of independence. She describes Vynca's home-based, tech-enabled, interdisciplinary palliative care model across California, Oregon, Washington, Utah, and Idaho, plus enhanced care management and a digital advance care planning platform used in 28 states. She discusses reimbursement challenges, noting Medicaid palliative care programs in California, Hawaii, and New Jersey and Medicare Advantage as current pathways, and explains transferring eligible patients to hospice when available while providing virtual hospice-like support in areas without access. Dr. Jill outlines practical ways to normalize advance care planning conversations and encourages patients and families to advocate for palliative services and proactive planning. 00:00 Welcome and Disclaimer 00:29 Meet Host and Guest 02:13 Dr Jill's Background 05:40 Value Based Care Explained 11:01 Patient Empowerment and Team Care 13:51 Vynca Locations and Services 15:07 Proactive Home Based Model 20:16 Access and Reimbursement Challenges 23:32 Hospice Transition and Rural Gaps 25:11 Advance Care Planning Tips 30:37 Final Takeaways and Closing https://www.vyncacare.com/ If you want to help, you can donate to help support Hospice Explained at the Buy me a Coffee link https://www.buymeacoffee.com/Hospice Hospice Explained Affiliates & Contact Information Buying from these Affilite links will help support this Podcast. Maire introduces a partnership with Suzanne Mayer RN inventor of the cloud9caresystem.com, When patients remain in the same position for extended periods, they are at high risk of developing pressure injuries, commonly known as bedsores. One of the biggest challenges caregivers face is the tendency for pillows and repositioning inserts to easily dislodge during care.(Suzanne is a former guest on Episode #119) When you order with Cloud 9 care system, please tell them you heard about them from Hospice Explained.(Thank You) Marie's Contact Marie@HospiceExplained.com www.HospiceExplained.com Finding a Hospice Agency 1. You can use Medicare.gov to help find a hospice agency, 2. choose Find provider 3. Choose Hospice 4. then add your zip code This should be a list of Hospice Agencies local to you or your loved one.
Matthew Zachary is a brain cancer survivor, healthcare advocate, founder of Stupid Cancer and We the Patients, and host of Out of Patients. In April 2026, he returned to the stage at Merkin Hall near Lincoln Center for his first solo public piano concert in almost 22 years while launching his debut book, We the Patients: Understanding, Navigating, and Surviving America's Healthcare Nightmare.What unfolded became far larger than a concert.Over 2 hours, survivors, clinicians, advocates, nonprofit founders, journalists, pharmaceutical sponsors, and healthcare insiders gathered in one room to reflect on 30 years of survivorship, institutional failure, accidental advocacy, and the emotional afterlife of cancer. The evening moved through original piano performances, live chapter readings, and deeply personal conversations about infertility, disability, financial toxicity, insurance denials, grief, burnout, and what happens when patients spend decades navigating systems designed around transactions instead of continuity.Guests including Wendell Potter, Maimah Karmo, Craig Lustig, Shelly Fuld Nasso, Tamika Felder, and others reflected on how the modern cancer advocacy movement emerged largely because patients built parallel systems where healthcare infrastructure failed to meet human needs. The conversation explored how prior authorization, reimbursement incentives, administrative fragmentation, and institutional distrust continue shaping the patient experience across oncology and survivorship.The performance also marked a deeply personal milestone. After brain cancer compromised his left hand at age 21, Zachary spent 6 months rehabilitating both hands to return to public performance for the first time in over 2 decades. The result became part concert, part civic gathering, and part historical record of a generation of survivors who refused to disappear quietly.RELATED LINKSMZLIVE Official WebsiteMZLIVE YouTube VideoFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
The World Health Organization has flagged loneliness and social isolation as a major public health concern especially for older adults. The organization says about 100 deaths per hour worldwide can be attributed to poorer health outcomes associated with loneliness. In the U.S., the over 65 demographic is growing rapidly. COVID-19 prevention measures and other factors such as financial constraints and the gap in digital access for this age group have exacerbated the issue. We've been exploring isolation and loneliness across other demographics such as young adults and new parents over the last few weeks. During one of those conversations, Jim in Massillon emailed us to say: "Not sure if there will be a second panel... but, hello, the danger point for most people is after the working life, when work-related 'friendships' go away. That is, late 50s to mid-60s and beyond." We heard your thoughts and we appreciate the comment, Jim. Wednesday on the "Sound of Ideas" we'll talk to representatives from social groups around Northeast Ohio that are working to help older adults build connection and community. Guests:- De'Neitra Brown, iConnect Director, Greater Cleveland Neighborhood Centers Association- Amanda Lathia, M.D., Division Chief, Geriatrics and Palliative Care, UH Cleveland Medical Center- Eleanor Bergholz, Author, "When Knitting Becomes Nurture"- Terry Vaiksnoras, Volunteer, Lake County Phone Pals- Kathey Fury, Participant, Lake County Phone Pals
In December 1996, a 37 year old pharmaceutical executive sat in a Borders bookstore reading medical textbooks on the floor, trying to understand a disease she had never heard of. Multiple myeloma carried a three year prognosis. Her daughter was 18 months old. Her father had just died of cancer. Within weeks, she pushed her doctors to say the quiet part clearly. This would likely end her life before her child entered kindergarten.Kathy Giusti refused to accept passive survival. She built a plan while the system offered fragments. She interviewed oncologists and fertility specialists at the same time. She pursued IVF to have a second child while preparing for treatment. She stayed employed to keep insurance coverage. Every decision carried financial, medical, and emotional risk.That same urgency exposed a deeper failure. Cancer research moved slowly. Academic centers guarded data. Clinical trials lacked coordination. Patients entered a system that demanded compliance without providing clarity. Giusti responded by building the Multiple Myeloma Research Foundation, not as a support group, but as an operating engine to accelerate drug development, fund research, and force collaboration across institutions.This episode tracks the tension between individual agency and systemic failure. Giusti describes how patients navigate diagnosis, insurance barriers, and fragmented care in real time. She explains how data, genomics, and clinical trials reshape cancer treatment while still leaving patients responsible for decisions they are not trained to make. She addresses disparities in access, the limits of early detection, and the reality that progress in oncology often depends on speed, funding, and alignment of incentives.The conversation moves between lived experience and structural critique. It names the cost of delay, the burden placed on patients to act as their own advocate, and the tradeoffs required to push a system forward that still protects itself first.⸻RELATED LINKSKathy GiustiMultiple Myeloma Research FoundationFatal to FearlessAmerican Society of Hematology⸻FEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
In this episode of Room 64 we are joined by Cheryl SpillerBarwon Health MND Palliative Care Shared Care CoordinatorSharing information about her role, Cheryl provides a rareinsight into the unique role and the importance of working with MND andPalliative Care teams and patients across the Barwon SW Region. Highlightingthe importance of good communication, sharing information and developingpositive networks to ensure we are providing the best possible palliative careservice to members of the community diagnosed with MND. In thelead up to the “Big Freeze at the G” on June 8th please takethe opportunity to listen to this episode and share through your networks tokeep these important conversations happening.
Palliative care in multiple sclerosis spans the disease course, from early screening and support after diagnosis to symptom management and quality‑of‑life optimization in midstage disease, and end‑of‑life care in advanced MS. This episode outlines a staged approach to palliative care, highlights the roles of neurology and primary care teams, and discusses tools such as patient‑reported outcomes and symptom scales to support ongoing assessment of patients and care partners. In this episode, Katie Grouse, MD, FAAN, speaks with Penelope Smyth, MD, FRCPC and Janis M. Miyasaki, MD, MEd, FRCPC, coauthors of the article "Palliative Care in Multiple Sclerosis" in the Continuum® April 2026 Multiple Sclerosis and Related Disorders issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California, San Francisco in San Francisco, California. Dr. Smyth is the director of the Division of Neurology in the Department of Medicine at the University of Alberta in Edmonton, Alberta, Canada. Dr. Miyasaki is a professor in the Division of Neurology in the Department of Medicine at the University of Alberta and the zone clinical department head for Clinical Neurosciences at Alberta Health Services in Edmonton, Alberta, Canada. Additional Resources Read the article: Palliative Care in Multiple Sclerosis Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Full episode transcript available here Dr Grouse: With the new treatments for MS, people might be saying palliative care is not relevant at all. It's about giving up hope and hopelessness. But this article covers why palliative care is important for your patients and families throughout their illness trajectory. Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Grouse: This is Dr. Katie Grouse. Today, I'm interviewing Drs Penelope Smyth and Janis Miyasaki about their article on palliative care in multiple sclerosis, which appears in the April 2026 Continuum issue on multiple sclerosis. Welcome to the podcast, and please introduce yourselves to our audience. Dr Smyth: Thank you, Katie. I'm Penny Smyth. I am a neurologist at the University of Alberta, a professor in neurology, and a clinical multiple sclerosis specialist. Dr Miyasaki: Hi, Katie. Thanks for having us. I'm Janis Miyasaki. I am a movement disorder neurologist primarily who also provides neuropalliative care at the University of Alberta in Edmonton, Canada. Dr Grouse: It's so great having you today to talk with us about your article. I thought this article was really a wonderful take on the topic. I learned a lot, and I'm really hoping all of our listeners will take advantage of this article and take advantage of all the learning they can get from reading about this topic. So, I wanted to start with a more general question, which is, what is the key message from this article that you're hoping your readers will take away? Dr Smyth: In terms of key takeaways, I think it's our hope that neurologists will come away from reading this article with, really, an expanded understanding of what palliative care is and how that might be applicable to them in their care for their patients with MS along a continuum of treating people with MS, that there can be components of palliative care and strategies that can be integrated early after diagnosis in, really, anywhere along the continuum of caring for people with MS. We've called that kind of mid-stage. And then there are particular needs for people with MS and their care partners in late-stage or severe MS and end of life that might require different palliative care strategies. I think we kind of have maybe a bit of a bias sometimes in thinking of palliative care as more directed towards those that are near end-of-life. But in fact, it's a much expanded concept. Dr Miyasaki: And I'll just add that we also discuss a palliative approach, that palliative care skills and philosophies can be used by generalists---in this case, neurologists who are providing care to people with MS---and that adopting certain skills and communication techniques can help us better address our patients' and their families' symptoms. And also to keep in mind that for most people with neurologic illness, the unit of care is not only the patient, but it's the patient and the family, however that family looks. Dr Grouse: Now, Penny, I'm curious, how are early-stage and mid-stage multiple sclerosis palliative care strategies different from, say, a typical evaluation and counseling that a neurologist would give, say, an MS specialist or even a general neurologist? Dr Smyth: Thank you, Katie. That's a great question, and something that actually I learned in writing this piece with Janice and from her as a neuropalliative care expert. I think in terms of early strategies around palliative care that can be helpful to the general neurologist in their office, palliative care is about holistic support for patients and their care providers spiritually, emotionally, physically. There are components of palliative care and symptom management and making sure that the patient is at the center of the care, as well as support for their care partners with their holistic approach of relief of suffering as well as offering hope. When I started this piece, I was thinking that many of us neurologists, I think, often informally utilize many of these components already when we're dealing with patients early on after diagnosis in terms of communication, counseling, and education; going through their fear of an uncertain future; spiritual well-being; and then connecting them with supports for adaptive coping strategies. And then as well in mid-stage, which is really around what we can do in symptom management and improving quality of life, with screening tools and patient-reported outcome measures. However, I have to say that there are many unmet needs for people with MS and their care partners that they identify that are clearly not being met by us neurologists in this day and age. So even though we may be incorporating some of these strategies, I don't think we're meeting the mark all the time and hitting the target, especially in our busy office practices, in various ways. Dr Grouse: Given that, at a high level, what are some important early-stage MS palliative care concepts that we should be keeping in mind when we are counseling patients in these stages of the disease? Dr Miyasaki: An important concept to keep in mind for neurologists dealing with early-stage MS patients is that for us, we feel successful that we have made a diagnosis. And yet for the patient, it is taking away that hope. Maybe it's not MS. Maybe I just have a numb hand and it's gonna go away. And for us to appreciate that while we make this diagnosis multiple times a week---or, for MS specialists multiple times a day---for this person, it is the first time, the first experience, and it shakes their entire foundation of who they are as a person, how they will perform all the tasks and roles that they have in society, in their professional lives, in their family structures, and in their close, intimate relationships. As physicians, we may be overwhelmed by acknowledging that. I feel that it's important for us to understand the needs that our patients have and to allow them to have their feelings. You know, feelings can feel messy and time-consuming, and yet when we fully see our patients, I feel that this is the best of medicine. And it certainly is, in terms of palliative care, the principle that we seek. We accept all of the patient, the joy and the sorrow, the anger and the frustration. We accept it all, and we try to determine what will serve this person who is suffering in front of us now. Dr Smyth: There's another piece to this, which came up as Janice and I were writing together. We were talking about offering a prognosis to a patient as to how they would do, and this was something that I thought deeply about, because I said, we always communicate how uncertain the prognosis is and how we can't predict the future. And then she said to me, well, what about offering a roadmap to a person with MS soon after diagnosis as to how you're gonna determine how they do over the next couple of years? Which are really important years in terms of determining how patients are doing on their disease-modifying therapies, whether they're having progression or not, and things. It's a pivotal time. So, if you can offer a roadmap to a person with MS and say, look, this is when we will be following you up. This is how we will be following you with MRI and biomarkers if you have that available, and this is how we will determine how responsive you are and then how we move forward from there. Dr Grouse: Really important concepts. And the roadmap certainly makes a lot of sense to me and something that, apart from just being useful to the patient for so many reasons to help set expectations, you know, is useful for us to better partner with the patient so they understand this is sort of how we do things and everyone's sort of expectations are met. So, I think those sound like really great goals and things to keep in mind. Now, we talked about early-stage MS palliative care concepts. How does that change as you get into the mid-stage of the disease? Dr Smyth: Yeah. So, this is reflecting the fact that the course of MS is so different and the experience of MS is so different person to person. And so, what do we do as neurologists when we follow these people long-term over years and decades of living with their MS as their needs evolve, as their symptoms evolve, and as their disability evolves? Well, really, this is about the time of getting into, what are the symptoms that they're struggling with, what are the causes of their suffering at various points? And then how do we identify that, maybe with use of patient-reported outcome measures, screening scales, things like that. And then how do we direct symptomatic management to the specific symptoms that are causing distress to the patient? As well as trying to improve their quality of life in various ways, treating their comorbidities, making sure to check on exercise, healthy living, and that kind of thing. Dr Grouse: Now getting into, I think, topics that we're more used to thinking about when we think about palliative care: a lot of us, I think, are really unsure of the right time to discuss advanced care directives in the course of multiple sclerosis, and I think that's not helped by the fact that many of us are just, in general, not terribly comfortable talking about those types of things in general. What is your advice to questions like this? Dr Smyth: And this is something that, again, Janice and I had to come together on, because there is no universal accepted time for when is the right time in multiple sclerosis to discuss advanced care directives and goals of care. And in fact, when they have looked at it in the literature, different things have come out. It has come out that neurologists can be uncomfortable discussing this. There's unique challenges to people with MS in that they have a diagnosis at a young age with an uncertain trajectory of how their course of disease is going to go. And many of these things lead care providers to be somewhat hesitant as to when is the right time, as well as, there were identified barriers within patients themselves as to when the right time might be to discuss. In that, you know, some of the coping strategies might be, as identified by some of the qualitative studies that have been done on this, around the fact that they would prefer to focus on the present rather than the future. In some studies expressed an ambivalence as to when they thought the right time might be, as well as some negative experiences that they might have had from providers trying to discuss these things in their previous experience. So, I went back to looking at the European guidelines for palliative care in MS, who suggested when a person might have severe MS---which they define as walking with bilateral aids for at least twenty meters or an EDSS of six or higher---or trigger-based, when there has been a change in the patient's status, when there's been a decline in some way or progression. Now, this is a little different, actually, than what we offer other people with neurologic diseases, and I don't know if that's the right answer. And this is where I'm going to turn it over to Janice, because I think we could learn something, as neurologists who treat people with MS, from our palliative care specialists. Dr Miyasaki: I think of advanced care planning in a very different way. I think what a lot of the patients were expressing in the studies was that being asked about advanced care planning signaled to them in some way that they have reached this point in their illness where things aren't going so great and I anticipate that you may run into complications. Whereas in our movement disorder clinic, one of our fellows did a study looking at capacity for decision-making. And even in people who scored normally on the Montreal Cognitive Assessment, they had impairments in some of the domains of decision-making. And so, our philosophy in movement disorders at least---and some of our patients are quite young who have multiple system atrophy, they could be in their forties---we take the philosophy that everyone over the age of decision-making capacity, which is generally eighteen, should have some goals of care established. And how I introduce it in my clinic is, you know, for the young resident, you want the full-meal deal, because the likelihood of the resident surviving the ICU admission is very high. And then when we look at me, who… I am older, the likelihood of surviving an ICU admission is considerably lower. And so, the appropriate goals of care might be that I am willing to go to the ICU, and if things go well, then they can continue. But if things are not going well, they can have a discussion with my personal directive or power of attorney to talk about what the goals of care should be. And then the other aspect is sometimes having the conversation with family is really important because most of our families in hospital express an uncertainty. Am I doing the right thing? And they want to do the right thing for their loved ones. And most people actually say, if you ask them, I don't want to burden my family with making decisions that are going to tear at their hearts. So, then we can't actually make good informed decisions for our loved ones unless we have clear conversations. I think it does speak to our superstitious beliefs that if we talk about death, it's going to happen. But I hope the listeners will take my word for it, it really doesn't. And someone had a really good saying about the advanced directive. They're kind of like evening clothes. You should take them out every once in a while and make sure they still fit. And so, when you normalize it in this way, it helps people to just say, oh, yeah, it's once a year. Dr. Miyasaki is gonna ask me about how do I feel about those goals of care. And then it doesn't have this portent of, oh, I'm not doing well. Instead, it's just, this is what we should all be doing for our sake and for our family's sake. Dr Smyth: Now, one thing that I have to add on to this is that it is important to try to establish advanced care directives before patients experience cognitive decline, because then that can make it a much more challenging conversation and brings nuances of challenge into the interactions, which, you know, are hard. Dr Grouse: And Penny, I'm glad you brought that up, because I was really struck by that point too when reading this article, how easy it is to miss the subtle signs that cognitive changes are happening. I think it's just- it's a good kind of segue into that topic in general, but it is such an important link to, you know, making sure that you get those advanced directives at a time when the patient's really able to express and understand what they're talking to you about. Now, on the topic of the cognitive screenings, what's a good way to do this type of screening, and why is this type of screening so particularly important in the case of multiple sclerosis? Dr Smyth: Yeah. Thank you, Katie. I think that it's important for our listeners to think about and recognize when we see our patients with MS because it is one of the invisible symptoms that people with MS can live with and may not be apparent on regular conversation in the office. So, it's important to deliberately ask about subjective challenges in cognition. Ask the partner about how they're doing in terms of their cognition in various ways. As well as asking them and exploring then, how are they doing in their professional roles if they're working or in their surroundings? How are they coping on a daily basis on a cognitive level in addition to a physical level? We know that cognitive issues are actually the biggest contributor for not working and are a huge driver of disability in MS in terms of functioning, even more than physical decline in many ways. So, it is important for us neurologists to keep top of mind and to think about and deliberately attend to. There are screening tests that we can do in the office. The easiest for us, which measures the verbal processing speed, is the SDMT test, which is a ninety-second test matching symbols and numbers. It's easy to do. You can train a MOA to do it before you see the patient and things like that, and it just gives you an idea as to where the patient is at. And usually they're having difficulties if they're greater than two standard deviations below the norm for their age, or if there's a significant drop of four or eight points, and that might signal to you that there might be more going on. You can explore it, and then if you do have this available, the ability to refer for neuropsychological testing if there's questions. But often we can't get it with the MoCA score, unfortunately. Dr Grouse: Talking about all these concepts, I think they all sound great. I think a lot of us hearing this will naturally say, "Yes, these are absolutely things we should be incorporating in the care of these patients." What I wondered about was, certainly we're all very busy, it is really hard to find time for a lot of these things. We don't always have access to specialists who can help us with some of these conversations. How can we find time, and how can we work this into the care of our patients effectively and still make time for all the other things we have to talk about, and make sure that we're seeing all of our other patients and staying on time and all of those things? Dr Miyasaki: Yes. I think that's the challenges of dealing with people who actually, over time, their care needs increase, is huge in neurology. I can't think of a single subspecialty where care actually gets easier. It's constantly getting harder. You know, having come from private practice, I completely understand my colleagues' challenges in the community. Some of the ways that other groups have managed this when they don't have government or university support in their center is actually to look at not-for-profits. There are a lot of not-for-profits that can help in terms of wayfinding for social services, explaining to the patients and the family what is available to them. And in fact, some of them can also provide some cognitive supports, as well as point them in the way of day programs. And many of them have very established caregiver support groups, as well as patient support groups for various stages of their illness. So, I think it requires for the individual or small or even a large group practice to be inventive, to look in your community and see what resources are available and free for your patients in order to establish that loose team without boundaries to help your patients. Of course, for those in academic centers, I know that times are tight for all of us, and if you haven't established a team, it is a challenge; and then learning how to write a business plan or a briefing note for your institution and to learn how to speak the love language of administrators, is really key to putting forward the needs of our patients. Which, compared to heart attack patients or hips and knees, they are very rare, and yet our patients can result in significant cost to the healthcare system. So, we do have an opportunity to make the case that putting a little bit of investment in the ambulatory setting can result in significant cost savings to the system when it comes to acute care hospitalization. Dr Smyth: So, I was thinking, Janis, as you were talking about that, when you were talking about not-for-profit groups, it's really the MS societies in various countries that are very active in this and have a lot of resources available, especially for care partners. Dr Grouse: Those are really great tips. Thank you for bringing those up as potential other resources we can take advantage of. I wanted to ask specifically about physician-assisted death and assisted suicide, which certainly does come up, especially in later-stage parts of the disease. How can palliative care specialists be helpful when patients do express interest in these types of interventions? Dr Miyasaki: As you know, Katie, in Canada, we've had a legislative right to access to what we call medical assistance in dying. When the legislation passed, one of my other colleagues and I felt that these were the only conversations we were having with our patients. In all this experience, I have sort of developed in my mind a framework of people who are what we call MAID-curious. They want to know what their rights are and how it would look, when they feel the time is close, for them to exercise that right. And then there are those who are fearful of future suffering. And some of them may have a very unrealistic view of what the future will look like. And this may be in particular for multiple sclerosis because many of the public's view is based on what treatment was like thirty years ago. It may not be informed by more recent treatment where patients actually do quite well, and the majority never get to progressive MS. And so, to explore and be open to that request is the first thing that is important. And then if the person has unresolved symptoms that, traditionally, we can't care for, the palliative care specialist can be very helpful because they just have inventive ways of looking at things. They look at it outside the box, and they have a different toolkit available to them. I would not want all neurologists to just send all these patients requesting physician-assisted death to their palliative care colleagues. But I think for those who are having unaddressed symptoms, it can be very helpful. Certainly, if there is an acute event in the hospital, then this is a time of crisis. And often hospitals will have an in-hospital palliative care team who can come and speak to the patient about what is going on and address some of their needs. And I would also like to emphasize the importance of spiritual care, because for many of our patients, they are not just having the physical suffering, they are also having the spiritual suffering of hopelessness or of feeling that they are a burden or that they just are not seen because a lot of the symptoms in MS are invisible. To have that understanding by a spiritual care counselor is really helpful for the people to feel understood and to reduce some of that suffering. Dr Grouse: That's a really great point, I think, to end on, and I think it really ties in a lot of the themes that we've been talking about today. Thank you so much for coming to talk with us today. It's been such a pleasure having you both here. Dr Smyth: Thank you. Dr Miyasaki: Thank you, Katie. Dr Grouse: Again, today I've been interviewing Drs Penelope Smyth and Janis Miyasaki about their article on palliative care in multiple sclerosis, which appears in the April 2026 Continuum issue on multiple sclerosis. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.
Send us Fan MailChronic conditions or a life altering diagnosis requires additional care beyond regular medical check ups. Learn what next steps could be part of your journey and the care support offered by a palliative care team. Support the showSeniorSupportStrategies.com when you need guidance navigating senior care or how to create your own Aging in Place strategy.
At 19, Shlomit woke up unable to speak. The right side of her body went numb. An emergency room sent her home and called it stress. That moment did not end in a diagnosis that changed policy or triggered reform. It sent her into a decade long pursuit of understanding how the brain fails language and how the healthcare system fails patients who cannot advocate for themselves.Shlomit trained as a speech language pathologist and spent years inside acute care hospitals and ICUs, performing endoscopies and treating patients with brain injury, stroke, and dysphagia. She watched medical teams rotate in and out, deliver dense updates, and leave families nodding without comprehension. She stayed behind and translated. Every day, patients told her she was the only one who explained what was happening. That gap is not an accident. Hospital systems optimize for throughput, not understanding. Patients move through beds based on cost, not readiness. Discharge planning becomes a financial decision wrapped in clinical language. A stay under 48 hours can shift the insurance burden dramatically, leaving patients exposed to higher out of pocket costs. Shlomit left the system and built Patient Path NYC, a private patient advocacy service. She now spends 15 to 20 hours a week per client reading charts, coordinating care teams, and translating medical decisions into plain language. Her work sits in the uncomfortable space between healthcare policy and lived experience. Families pay out of pocket to understand their own care. Hospitals benefit from the clarity she provides while maintaining the same structural incentives that created the confusion.This conversation tracks the human cost of fragmented care, the economics behind discharge decisions, and the quiet reality that patients who cannot communicate clearly often lose control of their own outcomes.RELATED LINKSShlomit LibertyShlomit Liberty on LinkedInPatient Path NYCBoard Certified Patient AdvocateFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
In 2020, developmental biologist Dr. Crystal Rogers drove the country roads outside Davis, California crying between grant rejections, wondering whether she was about to lose her lab, her career, and the scientific future she had spent years building. She had already done what academia tells young scientists to do. She earned the credentials. She landed a faculty position at UC Davis. She built a lab. Then the real test began.On this episode of Standard Deviation, Dr. Oliver Bogler examines the unspoken rules that determine which scientists survive academic research and which quietly disappear from it. The conversation follows Crystal Rogers and cancer biologist Dr. Michelle Mendoza as they collide with the “Hidden Curriculum” of biomedical science: the unwritten rhetoric, institutional signaling, and grant writing strategies that often decide who receives funding, tenure, and long term stability.Michelle Mendoza entered a tenure track position at the Huntsman Cancer Institute while raising 3 children, navigating a divorce, and trying to secure major NIH funding during COVID. What looked like objective scientific review turned out to depend heavily on persuasion, presentation, and insider fluency. Established researchers could promise massive research agendas based on reputation alone. Junior investigators faced a completely different standard.Oliver traces how the Life Science Editors Foundation and its JEDI program intervened by pairing scientists with former editors from journals including Cell and Nature. The work had little to do with commas or grammar. Editors challenged logic, structure, and scientific framing before grant reviewers could destroy an application in public.Both researchers eventually secured career defining grants. One realized she would keep her job and not have to move her family. The other celebrated by ordering a personalized “DEV BIO” license plate and driving through Davis blasting nineties hip hop and Beyoncé.The episode exposes how biomedical research funding rewards institutional fluency as much as scientific talent, and how hidden systems inside academic medicine continue shaping who gets to stay in science long enough to make discoveries.RELATED LINKSDr. Crystal Rogers LinkedInDr. Crystal Rogers Faculty PageDr. Crystal Rogers LabDr. Michelle Mendoza LinkedInDr. Michelle Mendoza Faculty PageHuntsman Cancer Institute Mendoza LabLife Science Editors FoundationFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Families who've lost a child say new funding from the government for paediatric palliative care will mean others won't have to do it alone. This morning, health minister Simeon Brown announced 15-and-a-half million dollars from Budget 2026 for two dedicated specialist teams in the North and South islands. Health correspondent Kate Green reports.
We all make mistakes. Sometimes we're able to brush off these experiences, but other times we're left with regrets. We regret that thing we said, how we handled that situation, or the choice we made. In this episode, host Samantha Laine Perfas, palliative care specialist Susan Block, neuroscientist Liz Phelps, and behavioral scientist Leslie John discuss how to make peace with the actions – or inactions – that still haunt us.
In 2008, Katy Talento walked away from Capitol Hill and into a Catholic convent. Within a year, she walked out. Within another decade, she sat inside the White House shaping health policy. Somewhere in between, she got labeled “infertile” after a single cycle of testing and spent years believing it.That label stuck. The pain that came before it never got investigated. Doctors offered birth control and moved on. No one asked why her body was struggling. No one followed the thread.Talento built her career inside the very systems she now critiques. She worked on federal health policy, global disease programs, and later advised the Trump administration on healthcare reform. She helped advance price transparency rules in a system where hospitals can still list 457 different prices for the same service.Then she left.Now she builds employer health plans that bypass insurers, PBMs, and traditional networks. Her approach replaces insurance contracts with direct payment, nurse navigators, and cost sharing models that promise simplicity but raise hard questions about risk and protection.This conversation sits in that tension.Talento describes a healthcare system shaped by layered incentives, where insurers, hospitals, and intermediaries profit from complexity. She argues that employers hold the leverage to disrupt it. The host pushes on what happens when patients fall outside those structures, when contracts disappear, and when community based models fail.The episode moves through infertility, misdiagnosis, insurance design, and the mechanics of employer sponsored care. It tracks how policy decisions made in Washington ripple into exam rooms, billing departments, and family lives.It also confronts a harder truth.Even insiders who understand the system can still get caught in it.RELATED LINKSAllBetter HealthKaty TalentoThem Before UsAn Arm and a LegRelentless Health ValueFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
In a wooded campground cabin in the early 2000s, 19 year old Ben Unger stood in the doorway and watched 20 naked men form a circle around a crying teenager. A counselor held up two tangerines and shouted, “These are your balls.” The exercise claimed to cure same sex attraction by forcing young men to “reclaim” their masculinity from overbearing mothers. Phones had been confiscated. Parents had paid thousands of dollars. Religion supplied the script. Pseudoscience supplied the props.Ben had grown up in an Orthodox Jewish community in Brooklyn and later studied in Israel to become a rabbi. When he admitted he felt attracted to men, rabbis told him to eat 7 figs a day, immerse in a ritual bath 5 times daily, or marry a woman and trust that “if there's friction, it works.” At 19, he entered conversion therapy through an organization called Jews Offering New Alternatives to Homosexuality, known as JONAH. He left with depression, religious trauma, and 6 months of silence toward the mother he had been taught to blame.Years later, represented by the Southern Poverty Law Center, Ben helped sue JONAH for consumer fraud in a landmark New Jersey case. The argument centered on evidence, not theology. Sexual orientation cannot be changed. The jury deliberated for 3 hours and ruled against the organization. The verdict helped reshape how states regulate conversion therapy and protect minors from psychological harm disguised as treatment.Today, Ben runs Buff Personal Training in New York City, a gym built on autonomy, mental health, and self respect. His story traces the arc from institutional control to self authorship. The conversation examines religion, LGBTQ rights, conversion therapy, consumer protection law, and the lasting cost of being told your identity is a disorder.RELATED LINKSBen Unger on LinkedInBen Unger on InstagramBUF Personal TrainingSouthern Poverty Law CenterJONAHFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
THE CHAPLAIN AND THE DOCTOR is filled with warmth and humor, this buddy film follows two unlikely allies working to bring curiosity, connection, and compassion to a broken healthcare system - one patient at a time. Betty Clark is an 80-year-old, African American chaplain on staff at The Wilma Chan Highland Hospital Campus, the level-one trauma center in Oakland, California. Jessica Zitter is a white Jewish physician who has been Betty's colleague on the Palliative Care service for over a decade. The two women are an unlikely team: chaplains and doctors do not usually pair up within the hierarchical and siloed halls of the hospital. Dr. Zitter, trained to believe in medical interventions and science, was not seeking a relationship with a chaplain. And Chaplain Clark never expected the doctor to take interest in her work. But with time, the two women's shared values and history overcome the forces that keep them apart, and they go on to do their best work together. THE CHAPLAIN & THE DOCTOR models a new kind of care, one that honors both spirit and body, the diverse backgrounds of patients, and the most human needs we all share. This is a must see film documentary not just about the story of two women who take their purpose and professions to help others, but we see that it help each other to become even better versions of themselves. #healtcare #doctor #chaplain #documentary #film #filmmaker #filmmaking #filmdirector #bondoncinema #medicine #faith #spiritual #healing
Drew Flugstad-Clarke never planned to work in brain cancer. She planned to play Division I soccer at Georgetown. She planned to paint. She even tried investment banking, answering emails at 4am in a cubicle that never slept. Then in June 2022 her father, Jim, was diagnosed with glioblastoma at 57. He died 1 day shy of 7 months later, just before his 58th birthday. His symptoms began with emotion, not seizures. A steady HR executive suddenly cried. His golf game slipped. By the time he entered the hospital for a scan, he did not leave without surgery. A subway poster for a 5K became a lifeline. Drew showed up. She found a community. She later joined the American Brain Tumor Association as Community Manager for the Eastern Region. This conversation walks through anticipatory grief, caregiving in real time, strategic numbness, and what it costs to curate hope when the median survival clock is already ticking.RELATED LINKSDrew Clark Flukestad on LinkedInTopor StudiosAmerican Brain Tumor AssociationGeorgetown University Women's SoccerFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
In this episode, Carla P. Cangemi, MD, FAAP, Vice President and Chief Medical Officer, St. Mary's Healthcare System for Children's, shares how the organization reimagined its palliative care program as Compassionate Care to better support children and families throughout every stage of the care journey. She discusses the multidisciplinary, holistic model, the importance of early trust-building conversations, and how family centered services improve quality of life and emotional support.
The new documentary "The Chaplain & the Doctor" spotlights the relationship between Betty Clark, a chaplain working at The Wilma Chan Highland Hospital Campus, and her colleague Dr. Jessica Zitter. The film follows their work together to try and combat implicit bias and racism in medicine. Clark and Dr. Zitter discuss the film, which premieres April 23 at the Angelika Film Center and will run at the Maysles Documentary Center. Film still courtesy of Reel Medicine Media
Janine Durso spent 30 years inside pharmaceutical advertising shaping healthcare narratives before becoming a belief strategist and founder of The Believist. In November 2024, during a routine Zoom coaching session, she felt what she called a sharp, terrible pain in the right side of her head. Within hours she was in surgery for a ruptured brain aneurysm. She does not remember the ambulance, the ICU, or the first weeks that followed. She spent 5 weeks in intensive care, then 10 days relearning how to walk, calculate simple change, and manage basic cognition. Doctors later placed a stent and continue monitoring a second unruptured aneurysm.This episode traces the moment she told her husband something broke in my brain, the 14 days doctors called touch and go, and the slow mental rebuild that followed. It also examines insurance barriers that require 2 direct relatives with aneurysms before screening coverage, and why she now lobbies in Washington for change.RELATED LINKSJanine DursoThe BelievistBrain Aneurysm FoundationWhite Plains HospitalDr. Jared CooperFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
© 2020-2026 Ivy Podcast Discovery LLC
