How and when to call palliative care

Did I tell you that I was a big fan of palliative care? Palliative care started around 15 years ago at the VA where I worked. We saw the service evolve. We saw how the palliative care approach improved the quality of both life and death. Many physicians have not yet accepted or at least understood palliative care. Many physicians use some palliative care principles and believe palliative care is superfluous. My experience is quite different. In the two hospitals where I have worked with palliative care, our patients receive a team approach to quality of life. The palliative care team designs a program for the patient and the family. Few physicians develop the skills of discussing advance directives and goals of care that our palliative care teams have developed. Few physicians have the time for the family meetings that often help achieve patient centered goals. Too often we see palliative care called to late. Palliative care does not equal hospice. Sometimes that involve hospice, but that is a separate and important approach. Many physicians think of palliative care for cancer patients, but we’ve seen great results with severe systolic heart failure, COPD, cirrhosis and CKD stage 4 or 5. We help our patients and their families when we involve palliative care earlier rather than later. I have developed a standard way to introduce the concept to patients. The students and residents find this introduction useful. When we suggest a palliative care consult, we m...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Attending Rounds Source Type: blogs