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New Board Certification in Hospice and Palliative Medicine
ABMS has defined the subspecialist in hospice and palliative medicine as “a physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.” According to Dr. Andrea Miller, medical director of Wuesthoff Brevard Hospice and Palliative Care in Viera, Fla., “All physicians practice palliative care–it is a normal part of excellent patient care. Subspecialty level palliative care consultation can be useful when the symptom management issues are complex, the family dynamics are chaotic, there is conflict among the decision makers or between the family and staff, or there are questions about the advance planning process. Palliative medicine physicians work closely with other members of the interdisciplinary team to help with the difficult decision making processes that often accompany serious and life limiting illnesses.” Hospitals have found that palliative care consultation services improve patient and family satisfaction while reducing futile interventions. In addition, studies have shown that patients who get early palliative consultation have fewer aggressive interventions with no increase in mortality rate or reduction in longevity. “Palliative care services differ from hospice services in that they can be delivered any time during a patient’s illness and they can be provided at the same time as aggressive curative or life-prolonging therapies,” Miller explained. “We, who work in hospice, have long recognized that there was a segment of the patient population who would benefit greatly from the services provided in hospice–but they either were not eligible for hospice or not interested in hospice. Palliative consultation gives us the opportunity to help these patients as well.” Physicians who do not often deal with hospice also may be surprised at the range of services and treatment options available in hospice, said Miller. “Hospice began as an alternative to usual medical care, but it has evolved into a benefit that complements standard medical care,” she said. “The hallmark of hospice care is patient choice. We try to delineate the options for the patient and their family, help them weigh the burden versus the benefit of treatment, and help them with the practical, emotional, and spiritual issues that they face at the end of life. Antibiotics, transfusions, IV therapy, nutritional support, radiation therapy, and chemotherapy are all choices which may be available to patients in hospice, depending on their plan of care and goals of treatment. The hospice and palliative medicine team is dedicated to supporting the goals and treatment plan defined by the patient, their physician and their family, in whatever way we can.” September 2007 Tags:NoneBookmark:
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