SFMMS Interview: Alex Smith and Eric Widera, Hosts of GeriPal Podcast

SFMMS INTERVIEW

Monique Schaulis, MD, MPH, FAAHPM

Dr. Schaulis interviews Alex Smith and Eric Widera, hosts of GeriPal: A geriatrics and palliative care podcast for every health care professional. We invite the brightest minds in geriatrics, hospice, and palliative care to talk about the topics that you care most about, ranging from recently published research in the field to controversies that keep us up at night. You'll laugh, learn and maybe sing along.

MS: First of all, I’m a diehard fan. I’ve been listening for years and find GeriPal to be an incredible source of up to date information that is really entertaining. Thank you for all of your amazing interviews! Can you tell us about how you got started? AS: We started the GeriPal blog in 2009 as a way to integrate the fields of geriatrics and palliative care. There was some friction between the fields at the time, “turf wars” over fellows and clinical service. We felt strongly that geriatrics and palliative care have more to learn from each other and can accomplish more together than separately. Our blog was targeted at health care professionals in geriatrics or palliative care. About five years ago we decided we wanted to go in a new direction and explore podcasting. Since then, we’ve expanded our intended audience, and our new tagline is “A Geriatrics and Palliative Care Podcast for Every Healthcare Professional.” Our goal is to educate all healthcare professionals about cutting edge issues related to the care of older adults and patients living with serious illness. MS: Did you have any idea at the beginning how big this podcast would become? How has it evolved over time? How many followers do you have now? AS: We had no idea how big it would become. At first, when we were a blog, we wondered, “Is anyone reading this?!?” When we transitioned to a podcast, we again wondered, “Will anyone listen?” We’re so pleased that there is an audience for our work (and it does take work to set up, research, and produce each episode). We currently average between three to five thousand downloads per podcast, about twice the size of a plenary session at an annual meeting of the American Geriatrics Society or the annual assembly of the American Academy of Hospice and Palliative Medicine. We’re growing rapidly, and have gained about 1,000 listeners per podcast over the last six months alone. EW: I wouldn’t say we're big, as we get about 3,000-5,000 listeners per podcast episode. But I don’t think you have to be bigger to make a difference. Most of our listeners are health care providers who want to change the world for older adults and for those living with serious illness, even if it is one patient at a time. If we can help them with that, even just a little bit, for me that’s the big idea for this podcast. MS: How do you choose whom to host? Do you peruse the latest journal articles and just call them up? AS: We are constantly monitoring the literature for articles that take a fresh look at issues, that tackle common clinical issues, or that bring real world practical advice that clinicians can use in everyday practice. We email the authors of studies or speakers we’ve heard at conferences. I can count on one hand the number who have said “no,” and we’ve recorded almost 200 podcasts at this point. MS: For me, the music really changes the feel of the episodes. What do you think? AS: I’m biased, but I love the music for two reasons. One, our speakers are often academic, and used to giving a grand rounds “talk-for-40-minutes” type of presentation. Those endless talking presentations make for a terrible podcast. The music gets them out of that frame into a more relaxed and non-academic mindset. Second, selfishly, I enjoy the music because I enjoy the challenge of learning and recording a new song each week. I can combine a life hobby with my academic work, which is a win-win in my book.

MS: How does asking your guests to pick songs change the conversations you have with them? Was this really intentional or more spontaneous? AS: It was very spontaneous. On the first episode, it was either Eric or Ken Covinsky who said, “Oh, and bring your guitar and play something.” EW: I would add that it makes the start of the conversation much more personal as, in a way, it invites you to see a side of the guest that you wouldn’t see just by reading their academic articles. This also sets the tone of the podcast that we are not just going to talk about what they found in their research, but also what makes it personally meaningful to them. MS: Have there been any musical interludes or episodes that were particularly notable? AS: The most memorable was when we attempted to sing Bohemian Rhapsody on a podcast with Melissa Wei about multimorbidity. Eric and Melissa both joined in (we were in the office singing together pre-covid). I gave up on the guitar part somewhere around “I see a little sillouhetto…” and we just went for it—out of tune, loud, laughing, and loving it. EW: I think back to some of the episodes we did early in the COVID pandemic. One in particular was with Jim Wright, a medical director for a 160-bed nursing home that was devastated by COVID. Listening to him talk, you got a sense of how overwhelming things got: “And then unfortunately, a hospital system which provided practitioners for over half the patients in our building, they quarantined their physician and nurse practitioner that normally came here and would not send any other replacement physicians. We ended up (me and my PA) with the entire building all at once. And so that first week was exhausting, and just very difficult to get through, day to day because you have your hands full seeing patients, writing orders and trying to keep them from crashing, but then you're also changing patients, making sure they're hydrated, helping with meal deliveries and things like that because of the under-staffing with the aides and the nurses as well.”

MS: What are some challenges you (and the podcast) faced? AS: Growing our listenership is our current challenge. Many podcasts offer CME credit. It would take a huge amount of administrative-type work for us to offer CME. I’m not sure we want to do it. We do this because it’s fun, and that might make it less fun. EW: As the production value goes up for the podcast, so does the cost. So funding the show becomes a challenge. We have been lucky to have had a three-year grant from the Archstone Foundation, but now have to look to other ways we can get sponsorship. MS: Is there something you feel most proud of? AS: When people come up to us at meetings, or relatives, or friends in healthcare and say, “I listened to your podcast on X.” Makes my heart sing. EW: Alex and I joke that the average readership of a traditional journal article is about three: the journal editor, lead author, and the author's mom. So, I’m also proud that we give those who are trying to improve the lives of older adults and those living with a serious illness another avenue to share the work that they are doing. MS: What are you looking forward to? AS: Helping people out by interpreting complex research articles for practicing healthcare professionals. Putting these studies in context. Having more fun with Eric and our guests. Singing new songs. EW: When we started the blog in 2009, I never imagined doing a podcast, but then seven years later we created one, and I love doing it. I look forward to seeing what comes next for GeriPal. I’m not sure we will see Alex doing TikTok dances, but I’m pretty sure in five years we will have evolved to something that I just can't imagine right now.

Alex Smith, MD, MS, MPH and Eric Widera, MD are palliative care physicians and Professors of Medicine in the UCSF Division of Geriatrics. Dr. Smith is a clinician-researcher and Dr. Widera is a clinician-educator. They both co-founded the GeriPal blog and podcast and ePrognosis, an online compendium of prognostic calculators for older adults.