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ABOUT ME

I am a family physician who practices hospice and palliative medicine at the VA Palo Alto in California.  I'm on the faculty of the Hospice and Palliative Medicine fellowship at Stanford University.  I created this blog to share resources, my thoughts, and selected writing.  My interests include pain medicine, human-centered design, medical education. Here is my CV.  

MIXED MESSAGES

The Insights, Inspirations and Introspections of a palliative care physician

Communication

FOAMED

Goals of Care

Healthcare History

Palliative Care

Primary Care

nausea

opioids

pain

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Nausea, Vomiting & Antiemetics

April 1, 2019

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Alex Sable-Smith, MD, MPH

In this video, I run through the basic pathophysiology, differential diagnosis, and treatment of nausea and vomiting. Click HERE for PDF summary of this video which I think will be a handy and useful clinical reference.  

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Lots of Pain Education

March 14, 2019

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Alex Sable-Smith, MD, MPH

I stumbled upon the University of Washington Pain Medicine website a few years ago when working on a quality improvement project in residence.  I re-stumbled upon it again and was reminded what a great resource it is.  The website is full of resources for practitioners...

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The Morphine Drip

March 14, 2019

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Alex Sable-Smith, MD, MPH

One of the most infamous treatments in medical care is the morphine drip.  While often associated with end-of-life care, morphine and other opioid infusions have a role in relieving suffering no matter what stage of illness.  They are indicated for severe pain or dyspn...

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Introducing Palliative Care to Patients

February 22, 2018

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Alex Sable-Smith, MD, MPH

Introducing palliative care to patients poses a challenge.  It’s a service that is unfamiliar or misunderstood by many patients and their families, so first impressions can make a difference on the relationship you develop with the patient and their family.  I struggle...

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YouTube Resources for Primary Care

January 15, 2018

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Alex Sable-Smith, MD, MPH

I spend a lot of time on YouTube.  In the small proportion of my hours on the site that I would consider productive, I've found some really helpful medical resources. There is lots more out there too in the realm of Free Open Access Medical Education (FOAMEd).

For Demon...

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When you have tears and only 10-Minutes: The BATHE Technique

January 15, 2018

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Alex Sable-Smith, MD, MPH

In a typical primary care appointment, you often have only 20 minutes to work with patients not only on the medical details of managing several complex diseases, but also addressing the emotional domain that accompanies illness.  That presents a huge challenge, and oft...

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The 5 D's: A Framework for Discussing Artificial Nutrition

December 18, 2017

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Alex Sable-Smith, MD, MPH

Food (and the eating of it) plays a central role in our experience of health and illness.  Think of whatever the latest health food craze is, or a parent feeding chicken soup to a sick child.  Many acute and chronic medical conditions alter a person's natural ability t...

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Nausea, Vomiting & Antiemetics

April 1, 2019

Lots of Pain Education

March 14, 2019

The Morphine Drip

March 14, 2019