Career Pathway

Hospice Associate Medical Director/Palliative Medicine Consultant
Christian Sinclair, MD FAAHPM

Institution: Kansas City Hospice

In medicine I find discovering new questions and searching for answers to be the most satisfying part of my daily work.  This curiosity led me to avoid fields where it felt like everything was already known and filled with guidelines, like cardiology.  When I stumped my attendings in asking how they qualify someone as 'poor prognosis' versus a 'guarded prognosis' I knew I was on to something which would satisfy my desire to push the boundaries of current knowledge and understanding.  In a hospice and palliative medicine practice the answers are never all there in front of you. By the very nature of its infancy, the field allows for creativity in prescribing, communicating, and problem-solving since the evidence base is still being formed.  And once we do start to get some answers through the growing research, new questions and dilemmas emerge to challenge our current knowledge and expectations.

My training goals reflected a desire to pursue primary care or geriatrics because of the rewards received from whole person care and not an organ or disease based approach.  You could say I was primed for palliative care.  I began my palliative medicine career as a 2nd year internal medicine resident at Wake Forest University Baptist Medical Center in Winston-Salem, NC.  During a week in which I drove home mired in self-doubt and fatigue about my chosen profession because I realized I had never been thanked, I had a spectacular encounter with a family which upended all my previous notions of what it meant to be a physician.

The patriarch of the family was dying in the Cardiac Care Unit and I was on-call when his condition really started to deteriorate.  Until this time, the family had already adapted to the frequent hospitalizations spurred by his congestive heart failure, so they had not yet discussed what might happen if Dad did not rebound like he always had before.  That evening during a meeting with the wife and three daughters they demonstrated anger and sadness as I carefully communicated his current condition and actually for the first time in my medical career told a family their Dad was dying right in front of our eyes. But at the end of the meeting I was hugged and thanked (also for the first time in my medical career) for helping them navigate a dark and frightening path.

I never realized my medical powers extended to helping people by having an actual conversation with them.  I had really thought until this point it was about numbers and tests and medicine.  The staff pointed me in the right direction to the local hospice medical director, Dick Stephenson at the Hospice & Palliative CareCenter.  He was looking for his first palliative medicine fellow and I was looking for guidance for my new inspiration.

Now as an associate hospice medical director and a hospital based palliative medicine consultant I am able to practice the full spectrum of palliative medicine.  While working for Kansas City Hospice and Palliative Care I am still able to have my foot in academia by being a site director for the University of Kansas Palliative Medicine Fellowship.  It has also been a real pleasure being a co-editor of Pallimed, which has opened so many doors and connected me with so many wise and people.