Page 10 - Delaware Medical Journal - September/October 2018
P. 10
LETTER TO THE EDITOR
PRESIDENT’S PAGE
competing drivers is exhausting. Continually being caught between the Hippocratic Oath, a decade of training, people at their sickest and most vulnerable is an untenable demand.” In addition,
they add, “Routinely experiencing the suffering, anguish, and loss of being unable to deliver the care that patients need is deeply painful. These incessant betrayals of patient care are ‘death by
a thousand cuts.’ Any one of them, delivered alone, might heal. But repeated
REFERENCE
on a daily basis, they coalesce into the moral injury of healthcare.”
The authors add that “moral injury is frequently mischaracterized. In combat veterans it can be diagnosed as post- traumatic stress; among physicians
it’s portrayed as burnout. But without understanding the critical difference between burnout and moral injury, the wound will never heal and physicians and patients alike will continue to suffer the consequences.”
Expanding the understanding of physician burnout to include the concept of moral injury should change both the discussion challenge for our physician workforce
in the future. I look forward to the continuing discussion.
Richard W. Henderson, MD
President, Medical Society of Delaware
www-bostonglobe-com.cdn.ampproject.org/c/s/www.bostonglobe.com/ideas/2018/08/04/physicians-aren-burning-out-they-suffering-moral-injury/ xGsJTQBHBzHdM2CvrWLa0M/amp.html
Dear Colleagues,
Thank you, Richard [W. Henderson, MD] and MSD for sharing the objective results related to the Membership Survey on Physician-Assisted Suicide in the July/ August edition of the Delaware Medical Journal.
However, [the fact that] 62% of colleagues
and palliative care programs and facilities in Delaware” or “I am unsure” related
to Question #3, Do you agree with the following statement, hospice and palliative care programs and facilities in Delaware,” alarmed me!
In Delaware, there are several hospice and palliative options currently available to our patients to support them in their desire to “age in place.” The Delaware Population Consortium recently released projections showing that our 65+
population will continue to grow rapidly, roughly by 75% from 2015 to 2050.
The majority of Delaware’s hospice care is currently being provided in the home. Medicare, Medicaid, and most private insurances cover the cost through the New Castle County, the Centers for Medicare and Medicaid Services (CMS) demonstrated that since 2010, the use of inpatient hospice beds for New Castle County has decreased by 3%, resulting
in our community needing end-of-life healthcare services that support them in their homes. The demand for one in-home hospice program in Delaware has grown by 9% since fall 2017.
Currently, there are several in-hospital palliative care programs offered, but only one in-home palliative care program offered in Delaware. With the shortening of hospital average lengths of stay, our
patients and their caregivers are taking on more complex medical tasks and they need the support of in-home palliative programs.
As a member of Delaware’s medical community, I urge each one of us to familiarize ourselves with the in-home options of care available to our patients. To remember that hospice care is about quality of life and to ask our patients and their families what are their end-of-life goals. Delaware’s current services are not only providing the highest-quality hospice and healthcare services, they are serving as a trusted community partner in end-of- life education and support.
Andrew L. Himelstein, MD, FACP, Hematologist, Oncologist
Medical Director of Delaware Hospice
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