Page 10 - Delaware Medical Journal - April 2017
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PRESIDENT’S PAGE
My nephrology fellows have found their two-week rotation with the Palliative Care service at Christiana Care to be invaluable.
struggle has led to the creation of mobile apps that we can use to quickly estimate morbidity and mortality. However, these formulaic approaches to patient care are not always accurate or in the best interest of the patient and can feel calculated and impersonal. How do we initiate these conversations? In the academic arena, residents are gauged on professionalism and interpersonal communication skills. Despite this, many residents feel that they did not receive adequate training with patients and their family members. Indeed, programs have been developed for just this purpose. Fellowship programs, especially those in oncology and others that deal with chronic
disease, are now adding conversational and palliative care training to their curriculum. My nephrology fellows have found their two-week rotation with the Palliative Care service at Christiana Care to be invaluable. It has enhanced their ability to have end-of-life conversations with both acutely and chronically ill patients and their families. Those of us who have been in practice awhile may
feel that formal conversational training is unnecessary, that it is an innate part
of being a doctor. These conversations are much easier to have when a long- standing doctor-patient relationship is
in place. However, we see these types of relationships becoming rarer as patients receive fragmented primary care through medical aid units and ERs. Most of
the time, patients see hospitalists in
the hospital rather than their primary care physician. Hospitalists are busy managing the care of several medically and surgically complex patients. The ability of our hospitalist colleagues to have these conversations with patients The need for a palliative care specialist is necessary and a welcome support in our new world of hospital medicine.
Additionally, the management of pain in these palliative care patients has also become an area of concern for prescribing physicians as we battle an opioid crisis. Working with the State, stakeholders were able to ensure that the new regulations on safe opioid
prescribing do provide exemption for hospice, palliative care, and active cancer patients. Yet, these regulations may still impact rapid access to pain control for this most vulnerable group of patients.
It is my hope that this special themed issue of the Delaware Medical Journal on Palliative Care provides you with valuable education and insight on this new medical specialty. For more information on palliative care training and how to have
• The Center to Advance Palliative Care – www.capc.org
• Vital Talk – www.vitaltalk.org
Prayus Tailor, M.D.
President, Medical Society of Delaware
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Del Med J | April 2017 | Vol. 89 | No. 4
