Dr. Doron Garfinkel is an Assistant Professor with specializations in internal medicine, palliative medicine and geriatrics; two year fellowship in clinical pharmacology at the Stanford university medical center, California. Previously head of a Geriatric-Palliative department, currently deputy head of Homecare hospice of the Israel Cancer Association, and geriatric-palliative consultant at the Wolfson medical center, Israel.
Main clinical and research activities concentrate on age-associated diseases, end of life topics including cancer, frailty, dementia, hip fractures and pressure sores. Particularly, research on sleep disorders and controlled release melatonin, and on "the war against polypharmacy". Dr. Garfinkel is trying to promote his Good Palliative-Geriatric Practice (GPGP) method to de-prescribe, a systematic approach to combat polypharmacy efficiently and safely, combining ethics, evidence based medicine and patient/family preferences. Dr. Garfinkel published the first prospective study in the scientific literature that focused on reducing the harms of polypharmacy while measuring the effects of massive de-prescribing on health outcomes and potential adverse effects of drug discontinuation. He showed that a simultaneous discontinuation of many medications often leads to improved clinical outcomes, including functional, and/or mental, and/or cognitive status with no significant adverse events. This was proven both in disabled patients in nursing departments (where mortality and hospitalization rates decreased as well), and in elderly people in the community (Arch Int Med 170: 1648-54, 2010). Since then, he has been successfully treating hundreds of elderly patients with drug discontinuation (de-prescribing). In 2013, Dr. Garfinkel with several other international experts have founded IGRIMUP - International Group for Reducing Inappropriate Medication Use & Polypharmacy (at the moment comprising renowned health professionals from 23 different countries). The goals of IGRIMUP are to improve research, education and clinical strategies designed to combat a major, though iatrogenic and preventable epidemic of the 21st century – inappropriate medication use and polypharmacy.