Geriatrics for the Masses: Rafael Duncan, Ellie Fishbein, Patty Lee, Sam Ing, & Stephanie Rogers

Eric 00:45

Welcome to the GeriPal Podcast. This is Eric Widera. This is Alex Smith. And Alex, we’re going to go viral today, viral for the care of older adults, how to bring geriatrics to the masses. Who do we have with us to talk about this.

Alex 01:00

We are delighted to welcome back Stephanie Rogers, who’s a geriatrician at UCSF, and she’s on Instagram @agewellwithdrsteph.

Alex 01:11

Thank you for joining us, Stephanie.

Stephanie 01:14

Good to be here.

Eric 01:15

Am I remembering correctly? You had a fiddle the last time you were on with us, Stephanie?

Alex 01:19

Oh, that was a few times ago. That was one of the first times. She’s been on many times.

Stephanie 01:23

Yeah, that was fun.

Alex 01:25

We’re also delighted to welcome Ellie Fishbein, who’s a geriatrician at Washington University. Ellie is on Instagram @geriatricsinreallife, one word, and she was featured in a JAMA news story titled A Growing Movement Aims to Prepare All Physicians to Care for Older Adults. Ellie, welcome to the GeriPal Podcast.

Ellie 01:46

So happy to be here. Thanks for having me.

Alex 01:49

And we’re delighted to welcome Sam Ing and Patty Lee, who are both geriatricians and co-creators of the VeryGeri podcast. Sam is at the University of Chicago and Patty is at the University of Illinois Chicago. Sam and Patty, welcome to the GeriPal podcast.

Ellie 02:07

Happy to be here. Thanks for having us.

Alex 02:10

And Rafael Duncan, who’s a geriatrician who we met in Brazil when we were down at the conference in Sao Paulo last year in the spring. Rafael is in Recife, Brazil, which was a town featured in the movie The Secret Agent. Great movie, by the way. And alongside Daniel Gomez… oh, I didn’t do that right, but it was close… he founded GeriClass, which is an online school dedicated to teaching doctors about geriatrics.

And they’ve been podcasting for a number of years on Spotify and YouTube, and also are working on a book. All of this is in Portuguese for our Portuguese listeners or those who have some Portuguese. Rafael, welcome to the GeriPal Podcast.

Rafael 02:54

Thank you very much. I feel very much honored.

Eric 03:11

Okay. So we’ve got a lot to cover, Alex. I think this is the most amount of guests we’ve ever had on the GeriPal Podcast. So we’ve got a lot to cover. But before we jump into the topic, who has a song request for Alex?

Stephanie 03:22

I do. I have picked Brad Paisley, The Internet Is Forever, because I thought it would be perfect for this topic.

Alex 03:32

This is more of the cautionary tale about the internet. Here’s a little bit.

Alex 03:39

(singing)

Eric 04:28

Oh boy. Definitely cautionary tale.

Alex 04:31

Little bit cautionary.

Stephanie 04:32

Yeah. There are a lot of things. I mean, when I got on social media, people started making fun of me immediately. So I thought that was pretty apropos. Like, you should be ashamed that you’re on social media.

Eric 04:43

Well, let’s talk about it. So we did a similar podcast on palliative care. So we had hospice nurse Julie, or Julie McFadden, on. We’ve had Matt Tyler on, on How to Train Your Doctor. We’ll have links to this in our show notes. Zine Zhao and Sammy Winemaker, the hosts of The Waiting Room Revolution.

Again, we’ll have a link to that in our show notes. We’re going to be talking about aging and geriatrics. Stephanie, since you brought it up, how long ago did you start doing social media and why did you start doing it? In professional life, not personal life.

Stephanie 05:14

Yeah. I mean, I started just a little over a year ago and I started doing it because I realized I was sort of in an echo chamber and sort of everybody I was talking to about geriatrics and our expertise in caring for older adults, we all knew. And I realized there’s tons of older adults out there that don’t have the most updated evidence.

There’s other doctors and health professionals out there that don’t have the most evidence. And where do they get their information? They get get it on Instagram, TikTok, YouTube, Facebook. And so I, we should be there.

Eric 05:49

And are you on all of them or are you focused on just Instagram?

Stephanie 05:52

I’m on all of them and I have recently started a Substack too. And I’m a big fan of Substack. Yeah.

Alex 05:59

Wait, what is a Substack?

Stephanie 06:01

Substack is like a blog and it also has like a Twitter-like component as well. I won’t say Twitter-like. It’s It’s not that chaotic. It’s more professional than that. But I think the big thing is that it is, you can write blogs. And so I’ll take videos that did really well on Instagram and then expand on the nuance in Substack. And it’s sort of a newsletter. So you have a mailing list. It actually goes to people’s email inboxes, whatever you write.

Eric 06:30

And is Instagram like your main focus or is…

Stephanie 06:33

Yeah, Instagram’s my main focus, I think.

Eric 06:35

And are people, Engaging with it? Like how, what’s your most popular post?

Stephanie 06:41

My most popular post had 7 million views and it was about hearing loss as being a risk factor for having dementia.

Eric 06:52

Wow.

Rafael 06:53

Holy… So it, it looks like your main focus is for doctors also, but there’s a lot of non-doctors listening, right?

Stephanie 07:03

I think my main focus is for older adults and caregivers of older adults, but I’m, I’m trying to subtly nudge other health professionals as well in a lot of what I’m saying. Wow.

Eric 07:15

I see.

Ellie 07:17

I do think that’s a good point. I was gonna say that one of the more difficult things about having a geriatrics account, and I’ve talked about this with some of the other geri docs who do it, is like, who is the audience? Because we do geriatrics to take care of older adults and aging people and kind of the family unit. And, you know, I don’t have a lot of knowledge of, you know, 90-plus-year-olds using social media.

Of course, there’s a few and they do it beautifully. And so a lot of the people using or interacting with my account at least are the adult children or, um, people who are interested in the field. And so the content is hard. Like, do I make the content for the caregiver? Do I make it for the older adult or do I make it for the learner? And I think I see everyone doing a little mix of, of each of those things.

Eric 08:05

And, um, you do a little mix for all of ’em?

Ellie 08:08

I, I think I lean more caregiver. Mm-hmm. Just because the, I think a lot of the Gen X and millennial users, and then maybe a little bit of the boomer population are my, my biggest interactors per the, and my very like minimal knowledge of using the data.

Eric 08:24

And are you just on Instagram?

Ellie 08:26

No, I’m on, I’m, I’m TikTok as well. TikTok.

Eric 08:31

Is this the same Geriatrics in Real Life?

Ellie 08:34

Yes. And the videos do better on that. And I, I have a video on there that’s like 2 million views and it’s on sundowning and the comments are ridiculous on that. It’s, it’s kind of funny, but.

Eric 08:46

All right, Ellie, how long ago did you start doing this and why did you start doing this?

Ellie 08:51

Probably the same time, Stephanie. I think I was late 2024, and I was a new attending. I had just recently attained like my AI scribe, and so I stumbled upon Hours to My Day and I was like, oh my God, I wanna do something creative. And so I started my account because I couldn’t really find any other geriatricians on social media. Now I, I can say that statement is very false. We have, there’s a lot of us now.

Stephanie 09:17

Yeah, we have like a geriatrics group chat on Instagram now, so we’re Oh, what

Eric 09:21

are, what are some of the other big ones out there that aren’t

Stephanie 09:25

with us? Kelly Takes Medicine.

Eric 09:27

Kelly Chung, right?

Stephanie 09:29

Uh, who’s wonderful. Anna Chodos has, uh, Words on Aging. I feel like I’m gonna leave some people out. I’ll give you guys something you can put in the show notes. We’ll put it in our show notes.

Eric 09:40

Yeah. Okay. Uh, Rafael. Oh, go ahead. Go ahead, Rafael.

Rafael 09:43

I’m sorry. We had that same issue in our very beginning. We, we wanted to do something focused for doctors. I was in residency. When me and Daniel and another friend of us, we joined together, let’s do something for doctors. And so, and we chose a very, very particular name for our podcast and Instagram account, which was translating for English.

It would be like aging well, envelhecer com saúde, aging well. And it, it was like a very good success, but it, it brought for us only people who wanted to Age Well. So it didn’t talk our name with our, our talk. And so we had to change the name 3 years after being there. And so today we are GeriClass and it’s, it talks much more with our audience, which is to teach geriatrics. So that was our main goal.

And so that was a very important decision we had to make because we wanted to to focusing doctors. So we, we, that’s our goal. So if you talk, that’s our perception. If we talk to the, to 2 people, to 2 folks, that’s clearly, and so the listener thinks that’s not for me and the other one, oh, that’s not for me. So who should be listening? And so we had this change of heart and we changed the name.

Eric 11:07

So let me ask you this, Rafael, you’ve been doing this for some time. You started You started on social media, YouTube, how long ago?

Rafael 11:15

In 19… 2019. It’s 7 years now.

Eric 11:18

All right. 7 years. And, um, for example, like you have one video, 5 Dangerous Medications for the Elderly. I think it has a quarter of a million views on YouTube. So quite the viral sensation. Was that the, was that Gerry Kloss or was that the one before?

Rafael 11:35

The one before.

Eric 11:36

The one before.

Rafael 11:36

So we get the millions when we get the, the, the patients, get the family. And we now, we do have like around 130,000 followers in Instagram, but we talk only about medicine. So evidence-based geriatrics for doctors. So that’s our goal. And, and that’s how we communicate. My patients don’t even know I have an Instagram.

Alex 12:04

Wait, are there 130,000 Portuguese-speaking doctors?

Rafael 12:09

Actually, we are over 60,000 here. 60, 600, actually. 600.

Eric 12:16

And do you think it’s just doctors or just healthcare providers? Like for me and Alex, our podcast is very much focused on healthcare providers.

Rafael 12:24

I don’t think it’s only for doctors. I mean, we can’t tell for sure, but it would be mainly doctors, but we have all sorts of Other professional providers.

Eric 12:35

Yeah. I, Patty and Sam, how did you get into, you, so you started a podcast. So similar to me and Alex, why did you decide to do that? Patty, I’m gonna start off with you.

Ellie 12:48

Yeah, we started, uh, when we were co-fellows at University of Chicago. I carried…

Eric 12:54

Very Jerry Podcast. That’s what you started, right?

Ellie 12:56

Yes. Very Jerry Podcast. Yes. During residency, I always listened to a podcast while I was washing dishes or driving after clinic. Me too. To just supplement didactics or textbooks to like think more slowly about how to approach AKIs and all that bread and butter stuff. So the podcast really came out of like these shower thoughts I would have during fellowship when I went home, like thinking about, ugh, like how could I have approached that? What framework do I have?

What’s the bread and butter for approaching something like falls? How does someone else approach this? Like a community hospitalist or a social worker or street medicine physician with fewer resources? I don’t, oh, how could I have communicated that goals of care better about feeding and things like that? So our focus is mostly towards trainees, so medical students, residents, fellows, just for that extra supplement if somebody wants to dig deeper or hear another perspective on how they approach things.

Eric 14:04

And you’re also on Instagram, is that right, Sam?

Ellie 14:07

Yes. Yep, that’s right. And I think for me, my driver for doing the podcast was being in a place for residency. I was at Highland, which is a county hospital in Oakland, and they actually don’t have any geriatricians there or geriatrics training that’s formal. And I knew that I wanted to pursue geriatrics, so I ended up doing an away rotation at UChicago where I am now. and also at NYU.

And I was just kind of blown away by the different perspectives that can come with being a geriatrician, depending on patient population and the, like the different values of an institution. And so, I was interested in bringing like all those different perspectives to residents in places where they didn’t have access to geriatrics education.

Eric 14:51

That’s awesome. And I love the focus on, on trainees. Uh, on Instagram, is it the same focus or is it

Ellie 14:57

On Instagram and our website, we mostly focus on infographics. So just like key points from each episode that you can get just scrolling, doom scrolling. The show notes are more expanded versions of the infographics. I find myself referencing them while I’m teaching trainees as well. It’s just kind of all there as an outline.

Ellie 15:23

So we mostly focus on like quick education resources.

Eric 15:28

And I’m going to start off with you, but I love everybody’s thoughts. Stephanie, I’m going to start off with you. Like, was there, is there a gap between how you generally taught in big ivory tower academic setting like UCSF, like academic rigor and versus making accessible content for the masses? Was that a training? Like, did you have to train yourself how to do that or it just came natural?

Stephanie 15:53

I am still training myself. I still, I don’t think I’ve perfected the messaging because we are taking super Super complex, nuanced topics that are usually very individualized to people and then trying to communicate it in 30 to 60 seconds. And sometimes I will think I have done that very well and I will put out a video and then the comments, I realized, oh my gosh, I just scared a ton of people. Or, oh my gosh, I didn’t address this actually huge caveat. You know? And so I, I think It is really difficult to do, and I’m struggling with it as I’m doing it.

Alex 16:33

Yeah. It reminds me of that Mark Twain saying, I would have written a shorter letter, but I did not have the time. It’s hard to condense the complex message into the attention span of today’s people, which is 30 to 60 seconds.

Stephanie 16:49

Yeah. And then you’re also competing with people who are being, you know, very dramatic about You know, wellness stuff or, you know, non-doctors, non-healthcare professionals saying who knows what, and you’re competing with that message. I’ll give you an example. I had a guy do a video about how statins cause dementia.

It got like 6 million views and I spent hours researching the topic to like debunk the myth. And I ended up talking to a bunch of people. I wrote out this very detailed script and my video got 20,000 views trying to like debunk this message. And so I’m really struggling with like, how do I make this interesting?

Rafael 17:32

It looks like you have to scare people.

Stephanie 17:35

Yeah. I mean, it’s one option.

Eric 17:37

It’s the algorithm that pushes content like that, right?

Rafael 17:41

Actually, that’s, that’s one of the main goals we have. Like we want to, to get rid of the misinformation here in Brazil. I don’t know, there’s probably the same. But we had a lot of doctors spreading out like misinformation and saying dramatic things about so many. I mean, it was so many fake news.

And, and so we wanted to make a good and very, very important message for other doctors. So we wanted to take care of the patient through another doctor. So we started making very long contents. Our podcasts are 1 hour and a half. We have podcasts. Yes, we have podcasts with almost 2 hours. It’s like big content. So we are lucky to have a very, very terrible traffic jam in most of cities.

Eric 18:34

We saw that in Sao Paulo, right, Alex?

Alex 18:37

Yeah, we saw some traffic jams. We were in some traffic jams.

Rafael 18:41

Plenty of opportunities to, to listen to our podcast.

Eric 18:46

So

Rafael 18:46

that’s

Eric 18:47

I was also noticing in Sao Paulo, my driver to the airport was also watching a soccer game on TV as he was driving us. So maybe they’ll watch your YouTube videos too.

Ellie 18:58

Stephanie, I really loved your statin video. And I will say that when you posted that, I thought to myself, she is braver than I am because I think there’s so much to go into. You’re so right, like catching the nuance of things. And I know that statins are very feared and a lot of people believe to be causative of dementia, like truly.

And so when I saw you put that video, I was like, oh, that girl better gear up for the comments cuz I’m definitely gonna look at those comments in like a few hours just so I can get a thrill, you know?

Stephanie 19:27

Yeah. And I try to remind myself too, Ellie, like even though I only got 20,000 views the other day, I was, I, I actually got to go to the, um, the tennis championship and I was sitting in a stadium and I realized, oh, this many people heard my take on statins. That actually is significant.

So even though I didn’t get the 6 million, like hopefully 20,000 is a lot. Like if you think about how many people read a study, I don’t know how many people read a JAGS article, for instance, versus like how many people heard that video. It really is significant. So I try to just focus on myself sometimes.

Eric 20:07

Well, let me ask you this. How do you deal? With, we were talking about misinformation. How do you deal with the comments, the trolls, the anger that I think social media promotes? I mean, I actually got off both Twitter, X, and Bluesky just because honestly it didn’t make me feel good. And I think the algorithm pushes anger.

Stephanie 20:31

Mm-hmm.

Eric 20:32

And those are the comments that get more comments and It just, um, it wasn’t worth it for me anymore. And I’m wondering, how do you think about that?

Stephanie 20:40

I stay out of them now. At first I was engaging with them and now I just, I like say, this is, you know, what I think is the most evidence-based thing to say is the best I can do. And I put it out into the world and I just leave it alone because it is same. It upsets me. It makes me feel frustrated. Um, it doesn’t make me feel good. And I just have to focus on and believe that what I am doing is Is the best that I can do to educate people. Yeah.

Rafael 21:10

Yeah. I think just like you, Stephanie, we do not go there in the wound. We don’t like poke the bear so many often, but we do have some bad comments now and then. And I am actually very good in ignoring it very much. So it really does not bother. I focus on the positive ones and So we do have a lot of positive reviews and talks, and that’s when I, my, my main focus. When the bad one comes, I’m, I can tell you, but I, I really don’t care.

Eric 21:46

Well, let me ask you this, Pat.

Rafael 21:48

Because I know, I know that we are doing everything based in science and, or, or in my experience. And so that’s my truth.

Eric 21:57

Patty and Sam, I gotta ask you, ’cause I actually feel the reason I like podcasts is it’s, it’s Honestly, more unidirectional. We have fun and like with, uh, like we actually just did a podcast on statins where there’s controversy and there was discussion about should we be using them in older adults, uh, which I loved, but I don’t, I don’t have to engage like a huge general audience and see all the trolls and the hate. Do you get a similar experience on podcasts or are you seeing something different?

Ellie 22:28

Thankfully, I have not had a lot of negative comments for our geriatrics education podcast, but just thinking about this conversation, I think it’s such a hard thing to go up against,

Ellie 22:40

like people who really want to lean into fear and then want like a definitive answer to a lot of questions that are really complex about aging. I think what we try to do in our podcast is acknowledge like what we don’t know, because I think that creates a lot of trust with our audience. Whether that’s like other providers or patients or caregivers who are listening. And I think we’ve tried to acknowledge with help of our learners actually like gray areas.

Ellie 23:06

Like, we did an episode on delirium and we were talking about, you know, we don’t recommend antipsychotics in any circumstance, right? Which is the safest thing for our patients. But then our residents and med students can kind of bring us back to, okay, but then what exactly am I going to say to the nurse at bedside? And I… do think that those kinds of honest conversations based on what is actually happening with our older adults creates trust.

Alex 23:32

Yeah. I listened to that podcast on delirium. I really enjoyed that. I thought there was a point where you acknowledge that there may be a time for antipsychotics when there’s a safety issue. People are under threat of, you know, being hurt, healthcare providers, others. I also learned some really interesting things.\

Like you could take a Dobhoff tube and like fix it to somebody’s a gown and then they’d have something to fiddle with other than the IV line, or you give them baby socks to fold and match up, like a task to do that they’re familiar with that might be more interesting. Really enjoyed that. Patty, thoughts?

Ellie 24:10

Yeah, that was a fun one with Dr. Jen Woodard. We actually were afraid of recording on Telegram because it’s been so done, but as the podcast kind of demonstrated, there’s always more ideas to learn from other people. Regarding the conversations part, I haven’t gotten negative comments specifically, but all of the comments and conversations we get are mostly in the podcast episode development process. So our trainees kind of help write our scripts.

Rafael 24:40

Oh.

Ellie 24:40

And, um, through that process they’re like, wait, um, what does this part mean? Or like, uh, I think this part doesn’t make any sense. Or, um, this. Uh, this part is really boring and long. So we like get the comments as we go, but not any of those like viral comments, um, that the others are interacting with.

Ellie 25:03

I think the nice part about having the resident is that they can say, oh, I don’t have a question about this, but you know, like my co-resident might have a question about this. So it becomes like a safer place to ask the real questions.

Alex 25:14

But Ellie, what do you think about this? I mean, a lot of people are leaving social media as we’re talking about because of the concern about, you know, they’re going for your attention. They’re going after your amygdala and your fear response. And this is so they can monetize it. And these oligarchs are getting rich off of our content. You know, what are we doing here? People are leaving and here you are making content and finding that this is important to you. How do you reconcile those issues at this time?

Ellie 25:50

Oh my gosh. I reconcile. I mean, it’s been a journey. I go through, you know, the realization of, you know, when you have people reaching out to you in the DMs to make a sponsored post and this, that, and the other where like, am I just here so that companies can make money and have like all sorts of, I go into geriatrics cuz I love the gray area, the existential questions of it.

And I find that everywhere I go, including social media. And I stay because of the connection. So I, you know, everyone in this group has been like immensely helpful in some way to me. And there’s constantly more who are joining. And so I think even though there’s The threat of people who, like, this is their sole source of income. I think it’s sort of beautiful that a lot of doctors who are on social media have a pretty steady source of income.

It’s one of the great things about being a doctor is the job stability. And so I’m not, you know, eagerly awaiting for a monetary post to be offered to me. And with that, I have a lot of creative control. And so there’s a lot of beauty in not having to make something that’s gonna go viral necessarily.

Alex 26:46

Yeah.

Stephanie 26:46

And I would say whether we like it or not, it’s where people get information. They’re getting their politics, they’re getting their weather, they’re getting their sports updates. Everything is coming from social media. And if we are not there as geriatricians, other people are and other people are telling them things. And so I think, you know, we have to do what’s healthy for us, but if we are not in the conversation, it’s, we are going to be left behind.

Rafael 27:11

Yeah. Perfect. You, you just remembered me right now. I had to, to explain for a lot of my patients actually, uh, one particular video that some guy here in Brazil recorded. He has 10 million followers, this, this doctor, 10 million followers. And he recorded a video saying tons of bad things about statins and telling them, but you have to take them, but take this another, this other one pill. So you have to take this 2 once. And, and all my patients went crazy and came to me and it was in my clinic and I, oops, wait, let’s, let’s talk about it. So I realized that this is a lot of misinformation that they’re giving to the patients. Actually, it’s not only for the doctors, it’s mainly for the patients. And so that’s another reason we are there also.

Eric 28:06

Rafael, but you’ve kind of switched, right, from patients to focusing on healthcare providers. Do you ever wonder, am I going to go back? Should I go back to the general population?

Rafael 28:16

I will not. It’s too… I’m too busy already with my doctors and my patients. I have like a very close connection with them and I have, and I talk to them, but for the social media, I just go for the… I’m a drug dealer who does not consume my drug. I just, I just provide content.

Alex 28:41

And Rafael, are you and Daniel writing a book for like healthcare providers or is the book intended for the lay public?

Rafael 28:50

For healthcare providers. We like, we are a school and we have other teachers who work with us. And so we wrote like this, like safeguard conduct. I don’t know, close enough, but I mean, we want the topics of the main chapters in geriatrics so that the doctors can use it like a guide. And we had many helpers with this book and in around April, I think it will be, it’s ready already, but printing and…

Eric 29:23

That’s great. Let me ask you this, because books and journals are the traditional realm of academia right there, but has your social media presence, YouTube videos, has that helped you in your academic leadership roles or promotions?

Rafael 29:43

Yeah, very much actually. We have, like, we have a very active social media Especially Instagram, and it has made us very active. I, I was like a faculty in a university for many years. I just dropped it because of my social media. It takes a lot of time.

Eric 30:03

Yeah.

Rafael 30:04

And yeah, and, and I have actually many patients that come through my social media and it’s been like quite a journey. Yeah. I work a lot.

Alex 30:14

And you have merch. I see you’re wearing a Jerry Class shirt. Look at that. Alex,

Eric 30:19

you’re going to make us some GeriPal Hawaiian shirts?

Rafael 30:22

I have like 20 of this one.

Alex 30:25

Also, first time our listeners will have heard this, Eric and I are thinking of writing a book that would be for the lay public, not for healthcare providers, although healthcare providers are soon going to agree. By saying that out loud, I hereby commit us. That’s right.

Stephanie 30:41

Now, Eric, to your point, can I make a point about The, I think social media has done tremendous things for my own clinical knowledge in geriatrics because I, like, we all know in order to teach something, you have to really understand it. And then people ask you questions like, well, what about this situation? Or what about this situation? Then you have to refine it.

And I feel like now I have my education much more on the tip of my tongue. And I also know where the gaps are. I’m about to come out with a Substack article about where I think the gaps are in, um, screening for cervical cancer after age 65 in women, because I’ve had these conversations on social media. And so I think it’s actually helping me be a better geriatrician.

Eric 31:22

Do you think it makes you a better academic person? Like, are you planning to write an article about this or do you think like, oh, like funny people? Yes.

Stephanie 31:29

And in fact, I’ve made connections with other gynecologists where I may write this article about the Pap smears and then another one on vaginal estrogen and use in women with dementia late in life to help prevent UTIs, et cetera. So it’s It’s helping me make connections with other professionals as well.

Eric 31:45

Patty and Sam, how long out of fellowship are you now?

Patty 31:49

We’re both about 2 years, 2 and a half years.

Eric 31:51

Have you noticed anything as junior faculty members?

Patty 31:54

In terms of like academic?

Eric 31:56

Yeah.

Patty 31:58

Actually, um, when we first started, I have to shout out to Dr. Chris Chiu. He’s a producer at the Curbsiders podcast, and he really encouraged us to see podcasting as academic development and activities. He really believes that digital education, he works at Ohio State. He was one of my preceptors.

Eric 32:17

Yeah.

Patty 32:18

He believes that digital education really has a place in academic medicine. So podcasting is like being increasingly recognized as academic activity, ways to collaborate with other institutions. Yeah.

Rafael 32:32

I used to study a lot. I wanted to, I need to study a little bit of anti-myeloid therapy. So I would schedule a podcast so it would make, force me to study more.

Eric 32:43

I do the same thing.

Stephanie 32:45

Same. Yes. Yes.

Rafael 32:48

I often, I learn a lot. Just recently we recorded one about migraine, migraine. And I, oh my God, I really need to study. There’s so many new drugs. I’m really not aware of what’s going on. So I called like 2 neurologists. Let’s talk about migraine. And it was very nice, actually.

Ellie 33:08

And I also agree that we learn a ton from our guests. Sometimes I hear the guests’ voices in my head when I’m doing a goals of care, when they’ve gone through cases with us, or we just did an episode with a neurologist about her take on how to talk with families after severe brain injuries, and it just helps me feel more confident cuz I have another tool in my toolkit, um, to talk to families. Sam, you were gonna say something?

Ellie 33:38

Yeah, I was just gonna say we are also learning how to formally evaluate podcasting as an educational tool. Um, we’re presenting at SGIM, the regional conference, but I think that’s one thing that we struggle with a bit because we don’t want it to be too cumbersome for our geriatrics learners and also are struggling to evaluate you know, what does it look like to retain this information? Like further down the line after listening to our podcast, was it, what does it look like 6 months from now?

Eric 34:05

And

Ellie 34:06

how does it change practice? So that’s one aspect of like our academic career that like podcasting has found its little niche

Eric 34:14

in.

Alex 34:14

Anything else? That’s a little bit separate, but you feel free to comment on that same thread. Have you been following this whole like controversy about what’s happening in geriatrics and you know, fellowship potentially not matching as well as, as it may have in the past and, and et cetera. I don’t know if that’s been something you’ve paid attention to.

Speaker 8 34:35

Oh, it’s like all I pay attention to.

Alex 34:36

Oh, okay, great. Yes.

Speaker 8 34:37

You’re in luck.

Alex 34:38

So what’s your, what are your thoughts? Like, what would you say to our audience about that? Where, where, where do you stand?

Ellie 34:44

I stand, we need more geriatricians. It’s the lowest filling internal medicine specialty. And I’ve always said it’s, it’s a hard business proposition to have people do additional training to see oftentimes more complex patients and then oftentimes make less money than their colleagues who would be able to see patients every 20 minutes. And so that’s a really hard sell.

And I’ll give a shout out to like my pediatric colleagues who I think when I talk to them, they’re like, welcome to our world. So I think it’s, you know, it’s not just geriatrics in the world of adult medicine. Geriatrics is in crisis, I would say. And part of, I think all of our goals is to not only make people interested in geriatrics, but I would love to have all my internal medicine trainees who I work with, I would love to have a cardiologist future who was like, you know what, I really loved my geriatrics rotation in residency and I’m gonna take those principles and apply them.

And I think that is an acceptable alternative if we can’t necessarily improve the pipeline, is to make sure that every specialty has their geri principles. Yeah.

Eric 35:54

Do you, do you think what you’re doing on social media is helping?

Ellie 35:58

I don’t know. I truly don’t. I have a lot of trainees and a lot of people who independently reach out to me and say how much my content means to them. And I take that to heart to know that if I’m even educating like one person about the existence of the specialty, that that is making a huge difference. And I don’t know how to quantify that difference, but I, I do believe that We do have a footprint.

Stephanie 36:23

I’d agree. I’ve had, I’ve had 3 people reach out to me saying that they were in some route of training, whether it’s medical students saying, wow, you’ve made me interested in geriatrics. Like, I didn’t even know it was a thing. Like, now I’m interested in it. And then I’ve had other medical specialists. I’ve had like a vascular surgeon write me and just be like, I take care of so many older people and I am learning so much from you. thank you for doing what you’re doing. So I, I, you know, it’s hard to quantify what’s happening there and this would be an amazing study to do, but I really do think we are helping the pipeline for geriatricians.

Eric 36:58

And Patty and Sam, your folk, you get a lot of input from trainees. Like, do you feel like you’re having an impact in maybe recruiting people into geriatrics?

Speaker 8 37:08

Yeah, I do think that we have an impact.

Ellie 37:09

We did like a qualitative study recently where They talked about feeling a little bit more comfortable doing like a holy, a holistic, like 5 Ms approach to geriatrics primary care. But what I’d also say is that some of the episodes which are geared towards physicians, including like communicating about stages of dementia or prognosis, people who are non-medical have reached out to us to say like, this content was helpful, even though it’s like not directed at patients or caregivers. Yeah. But that medical content has been helpful for them as well.

Eric 37:44

And I actually interviewed somebody who was part of your podcast too, one of the trainees. So, uh, I think it is having an impact. Rafael, how about in Brazil? Do you think what you’re doing with Jerry Class is having an impact?

Rafael 37:57

Actually, I think it’s having a huge impact because we do have a lot of courses. We have Like a, uh, prepare a pre-course for like certified board. I don’t know if that’s how you call it. I mean, we do have like, we end residency in geriatrics, so we have to apply for a test. So you have this, this board certified thing. I don’t know. We do have that here. So we have like a course so we can prepare the doctor just out of the residency or Who wants to apply for this test.

And we do have like over 500 students that we provide the course. Like we teach the whole lecture and stuff. We have like almost 200 doctors who want to have like a private practice in geriatrics. So we have like this teaching lessons and we do have like a very nice impact. So the podcast is not an end by itself. It’s like Uh, we start there. So we have people come over and so we do have a lot to offer. You see, we don’t end our work there. So we do have like many options. We have like for dementia courses, for palliative care, a lot of things.

Eric 39:16

That’s great. And I love the evolution of this too, and kind of thinking broadly. And I wonder if maybe for my last question. This is lightning round because we’re running out of time. Is the thing, where is this going next? Because I just think, uh, like me and Alex actually started off with a blog and we’ve evolved into a podcast and we evolved into getting onto social media. And, you know, sometimes it works, sometimes it doesn’t. We don’t have a lot of TikTok followers. We still haven’t cracked that nugget.

Rafael 39:47

Um, but really scary people.

Stephanie 39:49

More dancing,

Eric 39:50

more dancing, more dancing. Don’t tell Alex that.

Alex 39:53

We have one with a dance. But Eric refused to dance, so it was just me.

Eric 39:59

Where is Geriatrics for the Masses heading next? That’s my lightning round question. Like, where does this go next in this next evolution? And it could be small, it could be big. Just would love to hear your thoughts. Rafael, I’m going to start off with you.

Rafael 40:13

Where are we going next? Oh,

Eric 40:17

it could be you personally.

Rafael 40:19

Yeah. I don’t know. Let’s hear the folks.

Eric 40:23

Who’s got a good answer? Sam?

Stephanie 40:25

I got, I got an answer. Okay. I think everybody should be trying something. There’s a lot of, you know, different ways to get on social media. I would love it if social media and podcasting and Substack is flooded with geriatricians so that this language that we’re using in the world that we live in is just general conversation and generally known. And I would like to say like, Even just regular conferences. Yesterday I went to like a fancy women’s health conference in LA that was like non-academic and I got to teach geriatrics and it like blew people’s minds. So I think we just need to infiltrate normal, regular media.

Eric 41:02

To get out there. What’s one word of advice for our listeners, Stephanie, of what a geriatrician can do to start sharing knowledge publicly?

Stephanie 41:12

I think find something that works for your lifestyle and that you find interesting and you’re going to learn from and collaborate from and just start trying it. And like, I think all of us can agree that we’re all still experimenting. We don’t know what we’re doing. We’re figuring it out as we go, but we can all figure it out together as a community.

Eric 41:29

Ellie, go to your lightning round question. Where do you think we’re heading next?

Ellie 41:33

It’s been like probably less than 2 years since like the first Geri people were on social media and now we’re flooded with it. So I think that it’s only good things coming next. I would love to see Dr. Stephanie Rogers. on TV, I, I think that’s a great next step to get our voice out even further. You’re so good at speaking and, um,

Stephanie 41:55

thanks, Ellie.

Speaker 8 41:56

So I’m excited. Oh, thank you.

Stephanie 41:57

We need more of us. Yes.

Rafael 41:59

Yeah, I, I do think we have to speak more, although we do have like a lot of misinformation. We have to say the right things. When I told you about the, the, the video, the, the misinformation of the guy, I was worried about my patients. I feared them to drop the statin drug and I was truly, I was truly worried. So I had to do something. So that’s, that’s our next step. Do something. Do not stay idle.

Stephanie 42:29

Yes.

Eric 42:30

Patty and Sam, what do you think?

Sam 42:32

I would just say keep doing it. I mean, you never know who’s going to connect with what you produce. You never know what’s going to go viral. But as long as what everybody is saying, keep putting stuff out there, keep like permeating all the social media ways, um, keep talking about geriatrics. I think that’s really what we can do and doing what you love. I think a lot of people on this call are great at different things like social media, TikTok versus podcasting, and we all have different strengths and we should just keep honing that.

Eric 43:08

Wonderful. Sam, any other thoughts?

Ellie 43:10

Yeah, I think an important counter to the fear that we were talking about earlier is like the ability to tell the story of why we do what we do. And when I have learners in my clinic, I try to ask them first if they’re comfortable to like tell me about their grandparents or tell me about someone in their life who’s aging. And I think that helps center like why we are taking care of older adults.

Sam 43:32

And I find it a really powerful tool. I love that storytelling.

Eric 43:35

It reminds me of something I learned from Louise Aronson a long time ago is this concept of self-promotion, which we usually think is a bad thing. And social media does an incredibly good job of self-promotion, like on Facebook. But with that said, she kind of flipped it for me as using the self to promote the things that we care about, uh, using the self to promote geriatrics. And, uh, the stuff that you create may live on forever, which brings us to the song, Alex.

Alex 44:03

Good segue. Here’s a little bit.

Alex 44:07

(singing)

Alex 44:56

I had to edit those lyrics. There are some others.

Eric 45:01

Stephanie, Sam, Patty, Rafael, Ellie, thanks for being on this podcast.

Stephanie 45:05

Thank you for having us. Thank

Ellie 45:06

you.

Eric 45:07

And we have links to all of your social media accounts on our show notes. And thank you to all of our listeners for your continued support.

This episode is not CME eligible.

For more info on the CME credit, go to https://geripal.org/cme/