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I've often found the term "clinician" to be useful when the situation calls for being inclusive of various credentials. I sure disdain "provider" - and for that matter "consumer" when we are discussing health care. OK for buying bread.

In many years in home care, nursing home care, and hospice, I found it essential to hone those history-taking and physical exam skills. Out of the hospital, there's quite a burden in getting tests (and no help from a computer or curbside consult.

I'm excited for GUIDE, but I am also concerned about developing niche programs by diagnosis, rather than reforming long-term supports and services for all - including frailty, stroke, neuromuscular disease, end-stage organ failures, etc.

What a family bears with genetic dementia, carefully portrayed. Where's the community's support? nytimes.com/2023/07/20/mag…

Because, at least in my case, it takes quite some time and persistence to get through to a physician (and I'm one!) and then to get to a pharmacy that has the medication ready, since you don't want to stand there and cough. ANd it can be expensive! WHat a system!

PACE programs did remarkable adaptations through the pandemic - would that all of health care had been so creative!

Spot on! “But we are concerned that the naysayers will leave us with the status quo — and as we and others have argued, that is not an acceptable option.” We can’t let the industry kick the proverbial can down the road yet again!

And what have we done....nearly nothing. We are not even asking candidates what their plan is for the remarkable increase in elders needing personal care over the coming decade! When will we see polling and town hall questions on these issues?

Perhaps we should develop a metric for the proportion of public funds that go to resident care and require high performance on that metric - or limit the profiteering directly - e.g., no one can earn more than the President from public funds...let's get angry!

Good report - now, let's translate it to political action! Left to drift, we'll see millions of elders without housing and food, alone, and needing help - and many will "choose" to be dead instead. Is that what we want to look forward to??

Tweet of the day!

Maybe geriatrics should not be so polite. Maybe we need an Act Up for Old People! en.wikipedia.org/wiki/ACT_UP Require geri training in all Medicare-supported residencies. Pay off student loans for practicing geriatricians. Mimic PACE teams/comprehensiveness. Form alliances.

Sharon Brangman Congrats to you and all the other authors.

Maddening. And all the "providers" got paid. And it was rather more likely that the patient would not even have a temporarily good outcome - but would be more disabled and facing more suffering and disability - all contrary to her stated preferences.

Part 2 of nursing home ownership Eye on America story aired tonight on CBS Evening News. As I told lisaling "We need to know for every nursing home in the country how they are spending public dollars." Thanks to Michael Kaplan Norah O'Donnell 🇺🇸 & CBS News team for this important story.

what mis-statements by Mike Johnson - Social Security and Medicare are not "going bankrupt" (they are headed to reduced payments) and neither contributes to our national debt. Social Security needs more workers (immigrants!) and Medicare needs the Medicare tax to go to Medicare!

As a journalist, I can't stand this disparity.

Remarkable data. Politicians take note!

Experience the graphic art by a hospital nurse at apps.bostonglobe.com/opinion/graphi… Very sad - but grist for reforms!

GAO did a nice review of elder homelessness - only their recommendations were incredibly toothless - HHS should make sure ACL works on it with partners. UGH. Lay the responsibility on HUD! And the Older Americans Act gao.gov/products/gao-2…