One of the most interesting and worthwhile recent trends in healthcare is the rise in palliative care. It can provide a set of important choices when patients and their families face life-threatening illnesses. A recent article discussed the its upward trend. Below is an excerpt from the article (see: Hospital-based palliative care rises 19%)
The nation has improved its overall grade on providing hospital-based palliative care to a B, up from a C in 2008. The higher grade is due to a 19% rise in the number of hospitals with palliative care teams since 2008, according to a report released in October. The number of 50-plus bed hospitals with palliative care teams has nearly tripled since 2000 to 63%, said the research conducted by the Center to Advance Palliative Care...Eighty-five percent of hospitals with 300 beds or more have such teams in place, the report said. Palliative care teams are composed of physicians, nurses, social workers and chaplains who help patients with serious or life-threatening illnesses by treating pain and other symptoms, finding the best setting for the patient after discharge, and alleviating psychosocial and family burdens...."This is starting to become the standard of care throughout the country," said [an expert in the field]. "There is an accumulating body of evidence that not only does palliative care improve quality of life and quality of care but also significantly reduces hospital spending." For example, patients with lung cancer who received palliative care along with conventional treatment survived 2.7 months longer than patients who received only standard oncologic care, according to a [recent report]....There is one oncologist for every 141 newly diagnosed cancer patients, compared with one palliative medicine doctor for every 1,200 patients with serious or life-threatening illnesses, the report said. There are 73 accredited palliative care fellowship programs in the U.S. producing about 90 new palliative medicine physicians annually. The report calls for lifting the cap on Medicare-funded residency positions and redistributing some unused slots to accredited palliative medicine fellowship training. Despite broader availability of palliative care teams in hospitals, too often the patients' primary physicians wait too long before involving palliative specialists....
Like geriatrics, there will probably never be a sufficient supply of palliative care physicians. I am sure that the day-to-day work of these specialists can be stressful and certainly not as remunerative as, say, the practice of oncology. Nevertheless, it's a critical component in hospital critical care. The key to providing adequate services around the country, as noted above, are the palliative care teams composed of physicians, nurses, social workers and chaplains who attend to patients with life-threatening illnesses. This is an example of hospital-based multidisciplinary teams that must include physicians but which can extend the reach of palliative care physicians in the face of their current inadequate numbers (see: Can the Cleveland Clinic Model Be Replicated in Other Hospitals?). This sounds like a reasonable objective: lift the cap on Medicare-funded residency positions and redistribute some unused slots to accredited palliative medicine fellowship training.
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