Yael Schenker's guest appearances

Yael Schenker

GeriPal

Medicine Grand Rounds

The Medicine Mentors Podcast

David Reuben

Scott Bauer

BJ Miller

Charles Christopher

Andy Cohen

Kevin O'Leary

Aaron Kesselheim

Joseph Hill

Todd Barton

Thomas Russo

Louise Aronson

Haider Warraich

Lewis Cohen

Stephanie Rogers

Christopher Jackson

OwlTail

Bob Arnold

“The take home message of this  study is NOT that primary palliative care does not work.”  So says Yael Schenker of the negative study of an oncology nurse-led primary palliative care intervention for people with advanced cancer. And we pushed Yael and Bob Arnold (senior author) on this point - we have several negative studies of primary palliative care (see links below to podcasts)  - is it time to start to question the effectiveness of primary palliative care?  We certainly all agree on the problem: we have only enough palliative care specialists to care for some small proportion of the population of people with serious illness.  But when we move away from specialist palliative care to primary palliative care do we lose something critical? Perhaps we cannot train primary providers (front line nurses and doctors generally) to deliver palliative care that is “good enough” to impact outcomes. That’s one interpretation.  Another is that we need a “stronger dose” of primary palliative care.  In Yael and Bob’s  study nurses averaged 2.2 visits, hardly robust longitudinal palliative care.  Patients who had 3 visits had better outcomes. Unpacking negative studies is just as interesting as unpacking positive studies.  Knowing what doesn’t work is just as important as knowing what does. Links:   Negative multi-national study of primary palliative care in nursing homes  Negative ICU primary palliative care intervention  Project ENABLE  Podcast on palliative care’s diversity problem Systematic review of palliative care 

“The take home message of this <a href="https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2784167" rel="nofollow" target="_blank"> study</a> is NOT that primary palliative care does not work.”  So says Yael Schenker of the negative study of an oncology nurse-led primary palliative care intervention for people with advanced cancer. And we pushed Yael and Bob Arnold (senior author) on this point - we have several negative studies of primary palliative care (see links below to podcasts)  - is it time to start to question the effectiveness of primary palliative care?  We certainly all agree on the problem: we have only enough palliative care specialists to care for some small proportion of the population of people with serious illness.  But when we move away from specialist palliative care to primary palliative care do we lose something critical? Perhaps we cannot train primary providers (front line nurses and doctors generally) to deliver palliative care that is “good enough” to impact outcomes. That’s one interpretation.  Another is that we need a “stronger dose” of primary palliative care.  In Yael and Bob’s <a href="https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2784167" rel="nofollow" target="_blank"> study</a> nurses averaged 2.2 visits, hardly robust longitudinal palliative care.  Patients who had 3 visits had better outcomes. Unpacking negative studies is just as interesting as unpacking positive studies.  Knowing what doesn’t work is just as important as knowing what does. Links: <ul> <li><a href="https://www.geripal.org/2019/11/palliative-care-in-nursing-homes.html" rel="nofollow" target="_blank"> Negative multi-national study of primary palliative care in nursing homes</a></li> <li><a href="https://www.geripal.org/2018/06/doug-white-on-nejm-trial-breakthrough-or-bust.html" rel="nofollow" target="_blank"> Negative ICU primary palliative care intervention</a></li> <li><a href="https://www.geripal.org/2020/03/project-enable-podcast-with-marie.html" rel="nofollow" target="_blank"> Project ENABLE</a></li> <li><a href="https://www.geripal.org/2021/09/palliative-cares-diversity-problem.html" rel="nofollow" target="_blank"> Podcast on palliative care’s diversity problem</a></li> <li><a href="https://jamanetwork.com/journals/jama/article-abstract/2585979" rel="nofollow" target="_blank">Systematic review of palliative care</a></li> </ul>

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

Dr. Yael Schenker is an Associate Professor in the Department of Medicine and Director of the Palliative Research Center at University of Pittsburgh where she mentors numerous medical students, residents, fellows and junior faculty in clinical and research settings. Dr. Schenker completed her medical school, residency and fellowship in general internal medicine from the University of California, San Francisco. Since joining University of Pittsburgh, Dr. Schenker has collaborated on numerous palliative care research projects with a primary focus in understanding and improving provision of palliative care in oncology. She has published widely on topics including surrogate decision making, informed consent, healthcare advertising and language barriers. One of the most important tenets of good mentorship is practicing good communication. Be clear and upfront about what the expectations are of the relationship, says Dr. Yael Schenker. And when we seek out mentorship—look for the people who will support us and who we are comfortable being honest with. Beyond just communication with our mentors, she also encourages us to stay in communication with the world outside of the hospital. Understanding what problems humans actually care about is a way to find inspiration for our research. Lastly, be kind to yourself, especially in the face of failure. Pearls of Wisdom: 1. Know your why. When you know your why it gives you the stimulus and energy to pursue your passions. 2. Medicine is not a solo enterprise. It is a team sport. You need others around you who will build you up and provide you with encouragement. 3. Be kind to yourself in the face of failure. Try to look at situations from a productive perspective instead of growing frustrated and anxious.

Dr. Yael Schenker is an Associate Professor in the Department of Medicine and Director of the Palliative Research Center at University of Pittsburgh where she mentors numerous medical students, residents, fellows and junior faculty in clinical and research settings. Dr. Schenker completed her medical school, residency and fellowship in general internal medicine from the University of California, San Francisco. Since joining University of Pittsburgh, Dr. Schenker has collaborated on numerous palliative care research projects with a primary focus in understanding and improving provision of palliative care in oncology. She has published widely on topics including surrogate decision making, informed consent, healthcare advertising and language barriers. One of the most important tenets of good mentorship is practicing good communication. Be clear and upfront about what the expectations are of the relationship, says Dr. Yael Schenker. And when we seek out mentorship—look for the people who will support us and who we are comfortable being honest with. Beyond just communication with our mentors, she also encourages us to stay in communication with the world outside of the hospital. Understanding what problems humans actually care about is a way to find inspiration for our research. Lastly, be kind to yourself, especially in the face of failure. Pearls of Wisdom: 1. Know your why. When you know your why it gives you the stimulus and energy to pursue your passions. 2. Medicine is not a solo enterprise. It is a team sport. You need others around you who will build you up and provide you with encouragement. 3. Be kind to yourself in the face of failure. Try to look at situations from a productive perspective instead of growing frustrated and anxious.

Thinking Strategically About Mentorship with Dr. Yael Schenker