Read the full article from the summer issue of AAHPM Quarterly.
No matter where you live, if you’ve practiced palliative care long enough, one of your patients has asked you about medical marijuana. “Does it help pain? Does it help nausea or poor appetite? And, perhaps the scariest question for some of us, “Will you prescribe it for me?”
In a surprising move in November 2009, the American Medical Association changed its position on medical marijuana, calling for changes to encourage research about its potential benefits. Other influential medical specialty societies subsequently published similar position statements.
Intrigued by that trend, I co-presented a session about medical marijuana at the Academy’s 2011 Annual Assembly in Vancouver. Several attendees expressed interest in the topic and agreed that AAHPM should consider a position statement about medical marijuana. This article represents a written update of that presentation, and it revisits a controversial question: Should AAHPM consider creating a policy statement about medical marijuana?
by Larry Beresford
Most hospice and palliative medicine (HPM) professionals have been asked, “How can you do this work? Isn’t it depressing?” Depressing, some folks assume, because so many of the patients die, even though it is often expected. And yet, the experiences of those in the field is, in many cases, just the opposite—many professionals in the field report feeling uplifted, gratified, and hopeful because of the difference they are able to make in the lives of patients and families. An article in the AAHPM Quarterly summarizes data from the Academy’s Physician Compensation and Benefits Survey—2010 Report, other recent research, and the personal experience of HPM physicians to conclude that this work can be extraordinarily satisfying.
As a hospice volunteer over much of the past three decades, I can confirm the personal satisfaction that comes from making a tangible contribution to patients’ quality of life at a critical time of life. But physicians working in HPM may have additional benefits and job satisfaction from the varied opportunities for team leadership, program development, teaching, and research. AAHPM’s survey documents the wide variety of roles, settings, and job titles encompassed by the field of hospice and palliative medicine.
Another resource that has compiled the personal and professional stories of 17 physicians working in hospice and palliative medicine is the HPM Practitioner, an online newsletter published by the DAI Consulting Group. Brought to the field by a wide variety of paths and interests, these committed HPM physicians detail a range of job titles, duties, and responsibilities. But in most cases, they say they can’t imagine doing anything else than their current work in this field.
Larry Beresford is a freelance medical writer from Oakland, CA, who specializes in hospice and palliative care issues.
by Ruth Mugalian, Public Communications Inc.
Read the full article about defining palliative care in the Winter issue of The Quarterly.
When I talk about my work with hospice and palliative medicine specialists and why I enjoy it, I usually say something like this: “They’re doctors who take care of very sick patients. They relieve their symptoms and make them feel better.” It should be a communications professional’s dream. It’s simple, understandable and positive. There’s no esoteric medical jargon or complex technical language to translate into layman’s terms.
And yet, that simple, positive description doesn’t quite capture it.
Describing what hospice and palliative medicine specialists do is an evolving challenge, as evidenced by the many different ways the doctors explain their work. Unlike many other medical specialties, there’s no simple one- or two-word description, like “heart surgeon” or “cancer specialist.” “They relieve symptoms” is far too narrow, but also too broad. Don’t most doctors relieve symptoms? And, what about all the other care they provide: the help with decision making and navigating the system, the coordination of care, the support for families?
Just summarizing the breadth of care is challenging enough, but of course, there’s another challenge. The heart surgeon fixes the heart. The cancer specialist attacks the cancer. HPM doctors don’t cure. They provide the care that helps the surgeon and the oncologist cure, and that helps the patient endure the cure.
And sometimes there is no cure. That’s when the HPM’s role takes on special meaning and ironically and frustratingly gets twisted into something negative: they withhold care, give up on the patient, hasten death. Of course, the opposite is true. They stay on the job when others have no more to offer. They continue, or begin, providing care when others have stopped. They’re passionate about controlling pain. Snappy phrases are tempting: “They don’t cure, they care.” “They never stop caring,” “Helping you endure, with or without a cure.” They’re simple, understandable and positive, and they don’t quite capture it.
by Katie Macaluso, AAHPM Quarterly Managing Editor
If you’re a member of AAHPM, you should be spotting a copy of the fall issue of AAHPM Quarterly in your mailbox any day now (if it hasn’t arrived already). Pick up this issue to learn more about the 2012 Annual Assembly, certification deadlines, advocacy efforts, and where palliative care falls in the readmissions boom (a feature article by Larry Beresford).
One standout article in the fall issue is “A Lasting Gift: Organ Donation” by Lucille Marchand, MD BSN. In this Art of Caring column, Dr. Marchand discusses one patient’s struggle to plan for organ donation upon his death. The patient was diagnosed with end-stage amyotrophic lateral sclerosis (ALS) and hoped to find meaning in his early death through the gift of organ donation. As the patient and his hospice team worked to develop a plan that would allow for a comfortable death for him and the successful harvesting of organs, it became clear that too many risk factors might prevent organ donation from being a viable option for him. Read the full article here.
Helping patients achieve their final wishes is so important to all involved in the interdisciplinary team. Have you encountered a similar situation to this one? How was it resolved? Do you have advice for your colleagues in hospice and palliative medicine?