Understanding palliative care: An important part of practicing hospital medicine


This morning’s “Primary Palliative Care – What Every Hospitalist Should Know” is an introductory session on primary palliative care to help define the concept, illustrate the problem, and help troubleshoot barriers to practicing high-quality primary palliative care, according to Brett Hendel-Paterson, MD, FHM, a hospitalist at Region’s Hospital in St. Paul, Minn. and a presenter for this session.

Dr. Hendel-Paterson, Jeffrey L. Greenwald, MD, SFHM, of Massachusetts General Hospital, Boston, and Jeffrey Frank, MD, MBA, of Vituity, will each present on the topic of administering palliative care as a hospitalist and why it is important for hospitalists to better understand this area of medicine.

Dr. Brett Hendel-Paterson, a hospitalist at Region's Hospital in St. Paul, Minn

Dr. Brett Hendel-Paterson

A common misunderstanding about palliative care is that it is end-of-life care only, a misconception within both the medical and patient community. Most people believe that palliative care is associated with the “angel of death,” as Dr. Greenwald stated. Palliative care does encompass end-of-life care but is also associated with life-limiting illness. Both areas of palliative can be improved with better patient communication and symptom management.

As frontline providers at times of critical illness, and throughout illness, hospitalists are ideally positioned to provide palliative care services, Dr. Greenwald stated during an interview.

With hospitalists in such a prominent role in providing palliative care, Dr. Hendel-Paterson offered a detailed explanation about why the information from this session is important for hospitalists.

“The majority of Americans who die in this country die in hospitals. We see and we know that patients sometimes get more aggressive care leading to greater suffering in their final days,” he said. “As hospitalists, we are expected to be the primary physicians in the hospital caring for patients with a variety of health conditions. We are expected to have a basic expertise and be able to independently manage health conditions. For example, we are expected to be able to diagnose and treat pneumonia without consulting infectious disease or pulmonology specialists for basic care. In the same way, we must be able to communicate well with our patients and families and help lead them through discussions of prognosis and advance care planning. Primary palliative care refers to the skill set that includes communications about serious illness and basic symptom management.”

Dr. Jeffrey L. Greenwald of Massachusetts General Hospital, Boston

Dr. Jeffrey L. Greenwald

Dr. Greenwald expanded on Dr. Hendel-Paterson’s point concerning the growing need for hospitalists who are competent in palliative care.

“As the population ages, this issue is going to become more and more important for our field, because there isn’t a sufficient pipeline, current state – or predicted future state – of palliative care providers in hospitals to meet the need. So there’s a gap in the need, and that need is increasing.”

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