GeriPal Takeover! Nancy Lundebjerg and Annie Medina-Walpole

Nancy 01:30

Hi, welcome to the Geripal Podcast, which is going to be hosted by me, Nancy Lundebjerg, and my fabulous colleague, Annie Medina Walpole. Medina Walpole.

Annie 01:42

Hi, everyone. So surprise. This is the AGS GeriPal takeover. We’re representing the American Geriatric Society today and we are delighted to be here in the podcast. So let’s see here. I’d like to welcome Alex and Eric.

Eric 02:02

We’re old co hosts now, Alex.

Annie 02:04

I don’t want to be ageist.

Nancy 02:07

And we’re the older co host.

Eric 02:11

For productivity efficiency sake, we have now been removed [laughter].

Annie 02:15

You have been removed for this hour. So now you are the guests and we are the hosts. And along with Alex and Eric, we’d like to welcome Ken Covinsky. So, hi.

Eric 02:26

We found him in the hallway back there [laughter].

Annie 02:31

So if you go to the AGS meeting every year, you know that this group of three individuals comprises the AGS literature update. So this is something. This is the plenary to attend. It is a sold out crowd. It is a standup crowd and it’s going to be a hard act to follow. So we are here to celebrate Eric, Ken and Alex and talk a little bit about the history and kind of what made them do this through the years and where they see the future going for this amazing plenary session.

Nancy 03:05

And just not to do any sort of spoiler alert here, but 2025 is their last time doing this session at AGS. So if you have not experienced it live and in person, you should come to AGS. Of course. I will always, as always, say, you know, you’re welcome to do this in 2026. We will step aside.

Speaker 6 03:29

Andy.

Eric 03:30

I think this is, you know, why it’s our last year. We used all of our political capital to make sure it happens in Chicago, which is where we started for the literature Updates back in 2016, back when it was just me and Ken, and then we brought in Alex, like two years later. But Chicago, Ken, how are you feeling about Chicago?

Ken 03:50

I love Chicago. Go Cubs, go.

Annie 03:53

Oh, I’m going to tell you a secret, Ken. Guess what? I got invited to the Cubs game, so I’m going to see you there on Tuesday night.

Ken 04:00

So excited.

Annie 04:01

I grew up in Chicago, so back in seventh grade, I had a huge crush on Manny Trillo. Do you remember Manny Trillo?

Ken 04:07

Yes, I do.

Annie 04:09

Yes.

Eric 04:10

So Tuesday night of AGS Cubs Giants game, we will. We will see who everybody votes or roots for San Francisco versus Giant or San Francisco versus Giants Cubs.

Nancy 04:22

There’s also an AGS board dinner at the Cubs game. Skippy.

Annie 04:29

That’s why when you are an AGS president has been, you get to play the Cubs game. So I’m delighted. I’m delighted.

Eric 04:37

Do we get to hear at the end of this podcast who’s going to take it over? Just sneak peek to the future maybe. Okay. All right, let’s. Let’s jump in.

Annie 04:49

We’re still in the brainstorming phase.

Nancy 04:51

Yeah. So I think Annie has a little data for us to go over just to make sure everyone’s oriented. And then I got to choose the first article. And we have a song to kick us off that Alex chose, which is a tradition for the GeriPal podcast. So, Eric, even when you go away, we’re still going to keep Alex for the song.

Alex 05:15

Oh, really?

Annie 05:16

So if you look back in history, I think Eric and Ken have been doing this since 2016. Alex joined in 2018. So Nancy did some unscientific sampling this morning, and what we’ve decided, we think, think you’ve probably covered 150 to 175 articles, which is amazing. Alex, you’ve probably penned about 50 songs, which is also amazing. So if you haven’t been to this event, there is a literature review where we. We see the Data, we see the literature, and then there’s a fun sing along. So we’re going to show you a little bit of this today, a little flavor of that.

But first, let’s go back a little bit more in history. So my mentor, Bill Hall, did this. The Renaissance man. He’s amazing. Amazing. Did this a number of years. A very different spin to what you’re doing now. And then I vaguely recall maybe Louise Aronson came in as the heir apparent at first, and then you came. So how did you get roped into this? And why did you do this for almost a decade is a better question.

Eric 06:20

I got roped in because of Ken.

Ken 06:24

And I got roped in because of Eric, because I told Eric I thought this would be a great thing for him to do. And then Eric somehow thought that when he decided to do it, that I was supposed to do it with him.

Eric 06:36

Yeah, we heard words of caution from other people who used to do the updates, including Helen Fernandez, Raniere, Soriano, Rena, just about the amount of work that would take. And we heard that from Bill Hall, too, and yet we still did it. And the first two years we added some humor, but I think it really took off when we added the sing along thanks to Alex, which I think gave it a whole other level of the reasons why I love to do it.

Annie 07:05

Well, and that’s also the reason why it’s hard to get anybody who wants to follow in your footsteps, because, number one, most of us don’t have Alex’s voice or musical talent. But in spite of that, it is a lot of work for three individuals to pull all this together. I mean, back in the day, I think when Bill was going to step down, they said, hey, does Rochester still want to do it? And I said, that’s a hard no because I recognize how much work it is. So first, I want to thank you and commend you for what you have contributed to the American Geriatric society and to all of our collective learning.

Eric 07:38

Well, thank you very much.

Annie 07:40

Kudos to the three of you.

Eric 07:42

Alex are going to give us a little taste of what the sing along looks like.

Alex 07:46

Okay. So this is the first parody song I wrote. So these songs are all parodies. So Ken and Eric, they choose an article. They choose about 10 articles a year. And I write parody songs for about six or seven of them. This was 2018 in AGS Orlando, and they did a song about when to stop screening for cancer for colon cancer. And so we did this song. Let’s see if you recognize.

Alex 08:22

(singing)

Eric 09:37

I love that one. That was actually Ken, you remember that article, Nancy Schoenberg’s article on screening and what to say and what not to say to patients on how to talk. Yeah. How to talk to patients about screening colonoscopies.

Ken 09:56

We did a role play. We did a role play.

Eric 09:59

I don’t remember the role. What did we do for the role play? Ken?

Ken 10:02

You played a patient and I played the geriatrician trying to talk to you about screening and I didn’t do a good job.

Eric 10:12

So we used and I remember from that was the key take home message is don’t tell your patient you will not live long enough for this screening test. That there are better ways to actually have that discussion. That’s what I loved about that article.

Ken 10:29

Yes.

Nancy 10:30

So I think these control back because it’s my turn.

Annie 10:34

Can I just say one thing I want to say. So good, so good.

Alex 10:38

So good.

Annie 10:38

That was amazing. Sorry, sorry.

Eric 10:40

I will actually have a link to that article too on our show notes.

Nancy 10:44

Perfect. Thank you, Eric. So I think one, we should propose to the Red Sox that they substitute this parody version at every game. That would be great screening messages to a large audience. So Alex, you know, be prepared for the invitation. Two, Annie and I got a chance to choose an article to revisit. So we’re going to start this section. We’re going to have three sort of topics that we’re going to do. Ken got to choose one. Eric got to choose one.

Annie 11:21

Alex.

Nancy 11:22

Alex may have had a choice, but we’ll talk about that a little bit later. So our choice was Aducanumab. Well, maybe actually it was my choice and Annie just graciously agreed to.

Annie 11:35

I always agree.

Nancy 11:37

Essentially you chose this in 2021. There was sort of this great fanfare that there was this disease altering drug on the horizon at the time and you chose it as the drug of the year. And being chosen as drug of the year is not a mark of honor.

Eric 11:58

This is not what Ted.

Ken 12:01

What this is a good thing. What would make you perceive it that way?

Eric 12:07

It’s one of the highest honors in pharmaceutical company. It’s the drug of the year.

Ken 12:14

I’ll remind you, Nancy, that this is an honor for companies that manage to make lots of money despite having a product that’s worthless or doesn’t. Doesn’t do anything good. So this is like, you know, this is an ultimate achievement.

Eric 12:32

I mean, think about the business wherewithal to promote an article and make billions on something that doesn’t work.

Nancy 12:40

So before we dive into the conversation, which Eric and Ken are clearly ready to do, I think one of the reasons I chose this is, you know, I grew up watching Mary Poppins, and I really, really, really like this parody song from Alex. And it’s not a spoonful of sugar makes the medicine go down. So, Alex, do you want to take it away?

Alex 13:08

Sure. A quick story before I jump into this parody. This song got me kicked off a panel. This parody was seen on social media, and I was kicked off a panel to review the evidence for Educanumab to the trade off I will take. Here we go.

Annie 13:30

Maybe they’ll take you back now [laughing]

Alex 13:31

You never know.

Alex 13:36

(singing)

Nancy 14:29

All right. We actually have questions, but that was great.

Annie 14:34

That was amazing.

Nancy 14:35

Clapping Just as a side note, Annie really wanted to sing along with Alex, but Alex says, nah, doesn’t work. There’s a time lag on zoom.

Alex 14:44

Weird lag, terrible.

Annie 14:47

In May, you can stand up and sing along one last time. One last time.

Nancy 14:54

So the first question is really like, do you have any regrets? Was there? And maybe it’s more about was there Runner up drug for this choice? Like, how does the pharmaceutical company get what you’ve told us Right now is a great honor of being chosen as the drug of the year. How do they earn that? And Is there voting amongst your colleagues? Do the two of you go in a dark room?

Eric 15:23

It’s a really rigorous process, and I was actually just watching Succession last night, and they used the word meretricious, which. The definition, which I think is great because Alex used some big words in his song.

Alex 15:35

I don’t think that’s a word. Meretricious. Not meritorious.

Eric 15:39

Meretricious. Meretricious. I loved it. Apparently attractive, but having in reality no value or integrity. That is the definition of the award. And so we have a rigorous process, which is probably also. The rigorous process is also meretricious. But it’s me and Ken deciding which drug really stands out that year as being truly meretricious.

Ken 16:10

Yeah, we just decide which drug annoys us the most. Really.

Annie 16:15

I can’t wait to see this year.

Nancy 16:17

I love this.

Annie 16:18

We got a teaser.

Nancy 16:20

Yeah, I learned the word. Now, does Alex get any say in this? Because drug of the year always has a song attached to it. So is Alex allowed to say I guys can’t think of any song.

Eric 16:32

Alex can always think of a song for anything we throw at him. So it’s really impressive. I mean, the fact that you can do a song on Aducanumab.

Annie 16:44

Nancy, maybe this is our next fundraiser. So, Alex, maybe we record all of your songs and we sell them. At the age of.

Eric 16:52

What do you think?

Annie 16:55

I buy a CD of the songs.

Nancy 16:57

There are people that wanted us to do that, Annie. So, Alex 57, you know, we’ll hire you a recording studio.

Annie 17:05

And we have a recording studio. It’s right here.

Nancy 17:10

So there’s a follow up. Because one of the things that people really like about the prior version of the GeriPal podcast, before you and I took it over, Annie, is that it had some. It always has clinical relevance to practice today. So there’s two other drugs out on the market, and I kind of hang around meetings where people talk about these drugs.

Alex 17:36

Talking about anti amyloid drugs, prescribing.

Annie 17:39

Yeah, those drugs.

Eric 17:40

So you’re talking about Lecanemab, Donanemab, the two other or the two really only FDA approved drugs that we have available. Ken, you don’t have any thoughts on this?

Ken 17:49

Oh, I have no thoughts. Well, no, I’ll give a serious answer because it actually is an important question is the. My personal belief is that for these two existing drugs, the efficacy is very small and the side effects are substantial. That there’s almost no circumstances where if it was somebody close to me, that I would recommend it to them. And I see a path where a reasonable person might differ. So therefore I feel that I am obligated to tell patients about this option.

Eric 18:25

Yeah, I would add that I do think that there is a small select group of people where they would be willing to take the risks for this marginal benefit, which as a society I think we can debate is it worth approving these drugs? They’re approved. So I think for that select group, my biggest worry is the market is just not there for this drug. And what we’re seeing is that, you know, these drug companies are trying to expand the market through non normal means. So, you know, using telehealth companies to shuttle patients to neurologists who will, you know, prescribe the drug with questionable oversight.

And like, are they doing this for Eli Lilly to make money or are they doing this because this is the right thing for patients? So that’s what I worry about. And I also worry about this push towards just amyloid blood testing so as a way of diagnosing Alzheimer’s disease without doing the workup that’s needed beforehand. And I think there’s strong market forces both for that telehealth pathway and for just checking everybody’s amyloid status without really any good diagnostic reasoning and thorough exams and.

Ken 19:41

Amen. And actually, I’ll add one point that we’ve actually made repeatedly, you know, in this session over the years about how we prioritize health care and the needs of older persons. So that this is not something that might affect the individual clinician patient decision. But as a policy, we do such a horrible care of meeting the needs of patients with dementia and their caregivers.

And we have interventions and patient management interventions and caregiver management interventions that are so much less expensive and been proven effective and we don’t support them. And this complete lack of attention to the real needs of persons with dementia is really kind of a shameful part of US healthcare. And I think a point that you made, Eric, on a particle on hearing aids is probably providing persons with MCI with a hearing aid and the time and effort it takes to teach them how to use it effectively will do much more to improve cognitive function than any of these advocates.

Eric 20:45

Maybe we should discuss a hearing aid article. Hearing aid article in the future. We’ll see. You have to see about 2025 whenever that comes up, but we’ll see maybe.

Nancy 20:56

Over the counter hearing aids, you know, all kidding aside, and then I’m throwing the hosting duties back to Annie. Ken, I’ve always as a caregiver and consumer appreciated that you make that point over and over again because this particular class of drugs has a drain on resources that I don’t think we discuss enough in terms of the co payments and related testing and all of the other things that come along with the drugs. And I think that maybe gets a little lost and certainly I’ve written in jAGS about the language that’s used around these, this particular class of drugs that gets lost a little bit in the marketing translation just as the words disease altering somehow get lost in the marketing of these drugs. And Eric and I could probably go on for hours.

Eric 21:58

I’d also add that I wish this was an isolated thing with these drugs. It is not. I think these amyloid antibodies and how they’re marketed and the fiasco with Aducanumab is just a sign of where we are right now with increasingly expensive drugs. Half a million dollars for one year for another drug with exceedingly marginal benefits. Like you’re looking at the price of drugs and it’s just not sustainable for the marginal benefits that we’re seeing. And this is just the symptom of a much larger disease.

Annie 22:35

Right. And you know, and Ken, I love that you brought up the caregiver point. So my father passed away this past may probably more of a VASC dementia. But I think my mom did try everything. You know, they were in spite of it being a geriatrician. I think if this drug was offered to her, she was desperate to try everything as a caregiver. And I think that’s what’s hard. Right, that we’re not supporting the caregivers because they are desperate.

Eric 22:58

Yeah, yeah. And it’s interesting because the article that we did right after The Aducanumab in 2021 was the capable study which included everything what that everything included was a nurse visit at home, an occupational therapist visit and a handyman visit. And it worked. But we don’t offer that everything. We only offer everything if it’s something that is a device or a pharmaceutical. But God forbid we get a handyman to someone’s home.

Ken 23:29

Yeah, no, the capable study that actually was a presage of that was one of my two choices for my favorite article. But capable study was an incredible intervention. And to remind you it handyman to a person’s home, generally people of lower income, a $1,500 allowance to make their home safer and improve the lifespace and well being of the persons that are developing disability. That’s like less than one month month of these AB drugs.

Nancy 24:04

So classic classic geriatrics keeping people functional, independent and at home with some very sensible intervention. So Annie Since I was appointed timekeeper. It’s okay.

Annie 24:21

Well, let’s go. Let’s go back. So again, this is, this is a bit of an advertisement, but Saturday morning, which is. Is May 10th at 8:45 to 10:15 is the final session for these three. So please, we know you’re going to want to be there, but make sure that you attend and bring your singing voices and your tambourines and anything else you need to bring. So I’ve been on the program committee for decades, and I will tell you that this really is the favorite session for so many attendees. And I actually just pulled last year’s program committee to look and you are amongst the top. Even at a virtual meeting, people are going and people are listening to this.

So again, I commend you for that. So, but I want to move into what we’re going to call kind of a rapid fire session, and we’re going to do a bit of a review. So I’m going to ask Eric and Ken to identify their favorite topic that they’ve covered to discuss any of the updates that they’re thinking that can be relevant to clinical care of older people. And so Nancy and I, we don’t know what you’ve chosen. We said we wanted you to choose something. So we’re flying a little bit blind here, but we’re excited to hear.

Eric 25:31

Ken, this is like choosing which child you love the most. It’s impossible. Do you have one, Ken?

Ken 25:37

Oh, you know, it’s hard to pick one, so I will choose. I’m going to list two that were close to me.

Nancy 25:45

Just a note for everyone watching this podcast. If you’ve made it this far and think it’s a 45 minute podcast, I’ve got news for you. Might be a little longer.

Eric 25:56

What you got, Ken?

Annie 25:57

Chatty. I think we’re chatty.

Ken 25:59

We’re chatty. We’re chatty.

Nancy 26:00

Okay, Ken, take it away.

Ken 26:02

Okay. I’m gonna be very brief on the other two because of that warning, but Eric talked me into, in the first year in doing an article on the impact of rudeness on clinical care that.

Eric 26:13

Was actually one of mine. Ken.

Ken 26:17

You presented that. But it’s like, wait, that’s not Carrie Hendrix. But of course it is, actually. And it’s. And in an era, I won’t mention any names, but in an era where people sometimes think rudeness and meanness as a substitute for leadership, to remember that actually when you’re nice to people and treat people well, you actually get more out of them and they do better work.

Eric 26:40

Ken, Always yells at me when I don’t choose an article that is purely geriatrics. Like, it has to be people older than the age of 75, maybe 65. And that one was pediatrics. Was it a kid?

Annie 26:52

I was gonna say we learned that in kindergarten, but why don’t we do.

Eric 26:56

Was a pediatric article done in Israel? And what they did was they. They. It was a standardized patient. And then they inserted for some of them somebody who was rude. Like, like, say, back in my country, we would never have somebody as like terrible as you as a doctor. And then a condition where they weren’t rude. And it was fascinating. People performed better when rudeness was not part of the equation. So if we want to develop, let’s say, an organization around efficiency and productivity, I don’t know what to call it. Some like department of Productivity or efficiency. The key is not to be rude. That would be the one way to make sure that you have an efficient productive is avoid rudeness.

Ken 27:40

Yes. Yes. So no, an important. The message is not somehow been made to the general populace yet. So the second one I just mentioned was actually the capable study which we just discussed. And the one I’ll end with is study in JAMA Internal Medicine about the impact of an exercise intervention. And very frail. I believe the age range was over 80 hospitalized patients and showed that relatively light level physical activity, often with weights, improved hospital outcomes. And both. I love the message because again, it was a pragmatic study that showed that patients that we sometimes think cannot withstand exercise, they in fact do and they do better with it. And the confluence that somehow Eric got ahold of videos of the exercise intervention and Alex somehow, like put it, paired it brilliantly with a song that got everyone marching.

Alex 28:52

I would walk a thousand miles.

Ken 28:55

That’s right. Which was sung along with the video. Yeah. Yeah.

Annie 29:01

So I don’t think we’re going to hear that song yet. But before we segue to Eric’s favorite article, I think Alex has a song for us.

Alex 29:10

Wait, Eric, are you gonna talk about the Tim Anderson study?

Eric 29:14

No, but I can give a brief intro to it.

Alex 29:16

Can you give an intro?

Eric 29:17

Yeah, so. So Tim Anderson did a wonderful study looking at hypertensive management in the hospital. Is that the study you’re thinking about?

Alex 29:26

Exactly.

Eric 29:27

And initially the one we presented was like, what happens to people when they come to the hospital? What happens to all their blood pressure medicines? And what we saw was that people get a lot of intensification of blood pressure medicines during the hospital for no real good reasons because their Blood pressure was fine before they got to the hospital. And they go to the hospital and their blood pressure is a little bit up and it’s going to be fine when they’re discharged. So he found that we do this intensification and a follow up study showed that. That it doesn’t help to do the intensification. That’s what I remember for Ken. Anything else that you remember? Exactly.

Ken 30:05

I’ll tell you it’s not only that it doesn’t help, it makes things worse. So yes. And it actually, whenever I do ward attending, I always try to impress that article on the residence. It’s like just because we’re measuring blood pressure three times a day doesn’t mean you have to do something about it. That sometimes it’s just better to stand back and watch.

Eric 30:31

Yeah.

Alex 30:31

So this song is about an intern who’s been told, you have to treat this blood pressure. You know, you be a good intern. In the inpatient setting, if their pressure is high, you got to treat it to outpatient guidelines. But then that intern reads this article and that intern’s struggling with what to do. So here’s the song. Let’s see if you recognize this one.

Alex 30:59

(singing)

Annie 31:56

That’s wonderful.

Alex 31:57

That was a fun one.

Annie 32:00

Okay, so Eric, you’re up. Let’s hear your favorite art.

Eric 32:03

All right. Every one of them is like a little child. So it’s for me, I can’t choose which is my favorite, but one that did stand out a little bit was actually the very last one I presented, which is a deception trial. So this was a study looking at done in Texas, a randomized study looking at chair placement. So one group got randomized a chair that was next to the patient’s bed. The other group that got a chair, there’s still a chair in the room. Unlike usually at our hospital where we have to search for a chair, but it was in the closet. And then they looked at what happened afterwards and what they found was if you just put a chair near the bed more than half of physicians actually sat down to talk to the patient.

It didn’t take any more time. If you had it in the closet, almost nobody sat down. And then if you looked at outcomes like satisfaction surveys, HCAHPS surveys, it was actually improved in the group that got randomized to the chair next to the bed. And this just reminds me, because Mike Harper, past the AGS president, I see him walking down the hallway here at our hospital. He’s got, like, his little camping chairs, you know, aunties that he walks around with. I love that because it’s so hard to find a chair. But it matters. And I think those are the simple things, that it doesn’t require a $50,000 intervention. Sometimes it’s just as simple as making sure that you have a chair to sit down next to a patient.

Annie 33:32

Thank you. That’s a wonderful reminder. So, Nancy, I’m just realizing we didn’t ask Alex about his favorite article.

Alex 33:41

Oh, that was my.

Nancy 33:43

I might have had some offline conversation with Alex recently via email while I was in Las Vegas, or maybe I was in Death Valley. I don’t know if last week is a blur. Alex gets to choose a song, and he maybe got asked if there was, like, a teaser for AGS 2025. And. And honestly, this jury Pal takeover, just to be clear, wasn’t meant to be a teaser for AGS 2025, because our registration is through the roof already. So I don’t want anyone to worry. But I do think that knowing a little bit for the listeners who will be at AGS 2025 about what the folks might have planned just from the song Alex has done, I’d love to hear a collective clap at the meeting that you guessed it right, that the song told.

Annie 34:41

All right, I have a question. I’m going to say, does it have to do with Wicked? No.

Ken 34:48

You need to have a duet.

Annie 34:49

You need one of you two. Erica Penn needs to do a duet to Wicked. I challenge. I challenge you.

Ken 34:56

That would be who is who?

Alex 34:57

Who’s the Wicked?

Ken 34:58

It doesn’t.

Alex 35:02

You gotta get the green paint out.

Nancy 35:04

Just lay the ground rules. You’re not allowed to signal what your topic is that this song is related to.

Alex 35:11

Okay.

Ken 35:12

You know nothing.

Alex 35:13

Eric, were you gonna say something?

Annie 35:14

No.

Eric 35:15

Go ahead, Alex. Sing it away.

Alex 35:17

So in order to not give away anything that Eric and Ken are gonna talk about at each AGS, I’ve started to do a song at the beginning of the plenary session that is not related to one of the articles. That’s sort of like a feel good Said let’s make sure the audience understands the rules of singing. Like, some parts I sing, some parts the audience sings by themselves, and some parts we sing together. So that song is not article related. And sometimes it’s about the city we’re going to be in and of course we’re going to be in Chicago. So there was only one song to choose. Here we go.

Alex 35:54

(singing)

Ken 37:33

Oh, that hurt [laughing]

Annie 37:36

Other than that comment, I thought it was wonderful.

Nancy 37:40

What a great, great song choice. And now I’m feeling like I’m gonna have to figure out how to get a purple spotlight on. Alex.

Annie 37:49

That was fabulous.

Nancy 37:50

And smoke. Smoke, Right.

Annie 37:52

Smoke, mirrors and smoke.

Alex 37:54

There may be some Blues Brothers attire and I may be accompanied by somebody who was Miguel this last time.

Ken 38:01

We’ll see.

Nancy 38:02

I love it.

Annie 38:03

So you’re making me. So I went to medical school in Chicago and I got engaged in Chicago, and that night we went to a blues club with my sister and my husband, which was really fun. So you’re making me think that. Very fun. Okay, so we’re going to move into some of the future planning discussions and we really want your input. We want to pick your brains on this. Okay, so you’re leaving some very large shoes, a very large guitar, some very large headsets. You’re leaving all of that.

And we’re starting to plan for AGS and 26, which is virtual, and then 27, which is back in person. And so we kind of mulch over ideas. And one of the things we’re thinking about is having actually members suggest topics. And so we would have different groups, you know, so maybe there’d be a trio from, I don’t know, another institution that would come and would maybe present some teams to present. So what do you think about that?

Eric 39:01

I love anything that’s new and trying different things out. So, I mean, I think just Brainstorming great ideas like this. I think part of the reason that after doing this for nearly 10 years, we feel like it’s time to see what else is out there, what’s different and trying. Does it work, having other people try it? Similar. I think this is how me and Alex have always thought about doing this GeriPal stuff. Give it a try, see if it works. If it doesn’t work, move on to something else. I’m all for it.

Nancy 39:36

So we were really thinking of basically having different teams come up and present so that we try. We’d strive for a diversity of topics, but we would get members to suggest and give it a shot.

Eric 39:50

Yeah.

Ken 39:50

So just to clarify. So, I mean, I think this is a really interesting idea. So then rather than, you know, just one team, you might just say, what article do you want to present? And what do you want to talk about? And you might have, like, seven groups present seven articles. Five groups present, 10 articles. You know, that I think that’s a really interesting idea. You know, one of the things that, you know, that I would just urge others coming forward is be yourselves and do your own style. That, you know, I think over the years, like, you know, it started with RoseAnne Leipzig and company, and then, you know, before us, Bill hall, all the styles were different.

And, you know, I think the sessions under everybody who did it were well liked and popular, you know. Cause they all brought their own style and they all were educational in different ways. So that I like the idea of, like, you know, AGS is a really talented society, and we have really brilliant, bright, passionate, creative people. And I like the idea of, like, not dictating what this is gonna be, but letting the members, like, letting this come up from the grassroots and letting the members say.

Eric 40:57

And I’d add that Ken does a really good job of reminding us is even when we use humor, the songs, they’re always in the mission of, you know, the education part about a particular subject or article. So it’s never just to use the humor. It’s never just to use the song, but it’s to help the information sink in, Help think about how we should address these issues. And that’s why I love about that, like the parody songs that Alex does is it’s always on theme. It’s always about the article itself. And I think no matter what somebody chooses how they want to present the information, always thinking about what the needs of the audience are and what the goal of the updates is, and it’s to showcase the amazing publications that we’re doing. In geriatrics.

Annie 41:43

So do you have advice? So when you’re sort of sifting through all these articles in a year, what brings it to the top that you say? Because it’s not going to be about the song. I think that comes next. But what brings it to the top that you say? I think our members need to know this. And I love how you span an article about the chair to educate. There’s so much literature out there. So what advice would you give, Ken?

Eric 42:09

We got a simple rule. Do you remember what we start off with in how we select articles? I think, fundamentally, is it an important article? Does it have practical implications? So it’s not just like a theoretical thing, but we can do something about it? And is it interesting enough to commune, Ken, that we want to talk about? Does that sound right?

Ken 42:34

I think that’s great. I think that’s exactly right. So, you know, I think the primary measures really are. Is there something that we think the article can teach our audience and a key message for their practice or for the general policy of how we care for older people? And there is a little bit of peace of, like, we won’t present an article well if we don’t find it exciting and interesting. So. So it’s very arbitrary what ends up in those 10 articles, because there’s a lot of great articles. So we concluded that we have to enjoy presenting it as an important piece.

Eric 43:10

And our only exclusion is if the article is actually by Ken, me, or Alex. We actually don’t talk about it, but everything else is kind of fair game.

Annie 43:19

So we can talk about your articles next year.

Nancy 43:21

Yeah. So as we’re putting together the invite for members to submit ideas that they would present, that would probably be a key thing to say.

Annie 43:29

Like.

Nancy 43:30

Like, this isn’t an opportunity to talk about your own work.

Ken 43:33

Yeah, absolutely.

Eric 43:34

It’s to showcase other people’s work.

Ken 43:36

Yes. And part of this is, like, one of the things we really enjoy is that you absolutely cannot present your own article. So what part of your role here is to showcase the great work that people are doing in geriatrics and to lift up others?

Eric 43:52

And there’s a ton of that.

Ken 43:53

Yeah.

Annie 43:54

So do you wait? You know, you have nine, and then you just kind of wait till you have one in the queue. But do you wait to see if there’s some groundbreaking article that’s gonna come? You know? And are you. Are you. Are you all done, or are you going to be in Chicago? Not the night of the Cubs game, but after that?

Eric 44:08

Like, we want to make sure that we create as much anxiety for Nancy as possible. So we wait to turn in our slides and select articles to the last minute. We do year by year. We try to do it, you know, it’s not exactly by year, but a little bit close to. So we know we have enough time to think it through and give Alex some time. So that’s kind of how we do it. So we’re still kind of a little bit in the selection mode right now.

Nancy 44:35

I heard this rumor that you rehearse at home too, though. Do a dry run at ucsf. Or you stop doing that because now you’re just so good at this. You don’t need to rehearse.

Alex 44:49

We usually do a run through at the meeting. In person.

Ken 44:53

Yeah, no, we usually. About a day or two.

Nancy 44:54

We have to find out where that is.

Annie 44:58

I can imagine. Across the country. Does everyone email you after and go, hey, do you want to present at my grand rounds? I mean, does that happen?

Nancy 45:07

I’m gonna leave for this one.

Annie 45:11

Not the same exact articles.

Eric 45:13

I know.

Nancy 45:13

I had other organizations ask me if they could do this at theirs.

Eric 45:18

I’ve seen other organizations start doing this at theirs. So it’s happening out there, which is great. I love it when people riff and expand on the.

Ken 45:27

Yeah. I mean, what helps Nancy in trying to keep this exclusive is the pragmatics. And our meeting tends to come later than other meetings. And we do tell other organizations that it has to be at AGS first. So that takes us out of the pool for a lot of others.

Nancy 45:43

But now they’re free agents, Annie.

Annie 45:45

I know, I know. What are you doing next October?

Nancy 45:50

You know what? I’m going to send them a non compete class.

Annie 45:58

Okay, so what else, Nancy? What else do we want to ask this esteemed group?

Eric 46:03

I think. I think that’s it. I think we’re running out of time here, so. No, no.

Nancy 46:07

Well, one more. We still have. We still have time. Well, we have the regular usual question that I’ve asked you from the mic in the audience. And I’m not going to guarantee I won’t do that again this year. Any chance y’all would want to stay on for another year?

Alex 46:28

No.

Ken 46:30

Yeah.

Eric 46:31

It’s time for some new ideas.

Annie 46:37

Okay, so that’s you two. Alex.

Eric 46:39

Alex, that was me too.

Alex 46:41

That was all three of us.

Eric 46:42

Fresh ideas.

Annie 46:44

All right, so I’m going to ask you, Alex, what are you thinking? So we love the music. Music, right. This is. This is what. It just adds. It adds another dimension. Right? So you know, and we’re pretty famous at AGS for this. We’re kind of famous for the dance party. I’m just saying we. We go outside the box. So what do you think? It’s not a replacement, but what could be? What could we try?

Alex 47:09

I think that there are probably plenty of budding musicians, parody singers, there’s dancers out there who are just waiting for their opportunity to give it a shot. We’ll see. I hope so.

Annie 47:23

Nancy, do you think we’d let the institutions if they wanted to do a song? I mean, they’d have to have a. We’d have to have a. What is it called? Like a song.

Nancy 47:33

And I sort of probably are going to have a brainstorm after. I honestly thought probably not for 2026 because it’s virtual. So it’s hard if you don’t have an alex. But for 2027, if anyone watched the state voting at the Democratic Convention, which is usually a very boring thing, but this last presidential cycle, it was actually very fun. The song choices might have been very fun. I have some tricks up my sleeve that I’m going to call on Alex to help us with, Annie. Ok. We sort of replace him, at least for these bridge years.

Eric 48:21

I’d also add that you got a lot of energy and interesting ideas from the community, too, so you’re going to be fine. I do have to run to another meeting, so I hate to end this soon, but is there anything else on this takeover?

Nancy 48:36

There’s one other thing, Eric. It’s a pitch. You’re here till the end, and I am really hoping that you all will open up your wallet and donate to the GeriPal podcast to keep it going.

Eric 48:53

That’s a very nice pitch.

Nancy 48:56

And the URL I’m just going to give you, the words of the URL is givingtogether UCSF edu fundraiser 3618721. And those are all numbers. That’s not where it’s.

Eric 49:13

Or just go to the GeriPal website site and click the donate button [laughter]

Nancy 49:19

Alex and Eric, you know you have served a really important function for bringing together the Geriatrics and Palliative care community. Ken, you’ve been a frequent guest and kept them honest many a time. And again, we are ever so grateful at AGS that you one, said yes in 2016 and two, that you kept with us, us all these years. And all kidding aside, we will send you off into the sunset for another Cubs game on Saturday, May 10, and be forever grateful for your contributions to us.

Annie 50:00

This is the most fun I’ve had in a long time. Taking over the podcast. And if you need someone else, if you need some co hosts, Nancy and I, you know, we can be enticed to each other. Yeah.

Nancy 50:10

Apparently, we felt the timing thing.

Alex 50:14

Thank you both. Both. Those are really kind words.

Ken 50:17

No, thank you. And we’re really grateful for the opportunity. And this is sort of obvious. We’re very proud to be part of the geriatrics community and the AGS community. And, you know, we feel, you know, we’ve had such great colleagues through this community and, you know, we enjoy being a part of it.

Eric 50:33

And we’ll see you all in Chicago.

Annie 50:35

See you in Chicago. Thanks.

This episode is not CME eligible.