Archive for April, 2011

Lessons Learned at the ACP Meeting: Where do we go from here?

Steven (Skip) Radwany, MD, FACP, FAAHPM, is the Medical Director of Summa Health System’s Palliative Care and Hospice Services, and Professor of Medicine, Northeastern Ohio Universities Colleges of Medicine and Pharmacy. Dr. Radwany is the AAHPM Ethics, Advocacy and External Awareness Strategic Coordinating Committee Chair.

This comes in follow-up to my post a couple of months ago regarding our relationships within organized medicine and academic medicine via the Academy. I recently attended the American College of Physicians (ACP) Annual Meeting in San Diego, California, from April 5-10, 2011. I was able to obtain some of those valuable Maintenance of Certification Points during a pre-course in order to finalize preparations for my Geriatrics re-certification.

As always, this ACP sponsored meeting offered hundreds of excellent presentation from which to choose. The schedule exhibited great depth and breadth in with one significant exception:

Out of the hundreds of subspecialty and generalists offerings, including a complete track for hospital medicine, there were only 2 explicit Hospice and Palliative Medicine offerings on the schedule. These were provided by Jean Kutner, AHHPM Board Member and Keith Swetz, AAHPM Member.

Under listing of topical areas on the schedule included all of usual suspects: Cardiology, Dermatology, Endocrine, Geriatric Medicine, Gastroenterology, etc., yet Hospice and Palliative Medicine did not appear to be recognized as a distinctive or important specialty.

Nonetheless, the largest proportion of certified Hospice and Palliative Medicine specialists are internists. Additionally, the largest proportion of Hospice and Palliative Medicine Fellowship Programs are housed in or attached to Internal Medicine Programs. Thus Internal Medicine and Hospice and Palliative Medicine are clearly joined at the hip. Yet the relative absence both in name and person from Internal Medicine’s largest annual meeting suggests a bit of a disconnect.

We must collaborate extensively with Internal Medicine generalists and subspecialists in order to provide the highest quality care to our patients. We certainly need to be fully recognized and able to stand tall amongst our fellow Internal Medicine subspecialties. Some of the disconnect could reflect the integrative character of out specialty, yet General Internal Medicine, Geriatric Medicine, and Hospital Medicine all have prominent roles in this annual meeting.

Another barrier or concern might be the large number of sponsoring general specialties from which one can enter the field of Hospice and Palliative Medicine including Radiology, Pediatrics, Neurology, etc. This broad “ownership” of Hospice and Palliative Medicine may dilute the attention of organized Internal Medicine to our field though dual sponsorship of Geriatrics by Family Medicine and Internal Medicine has had no such effect.

So, where do we go from here? The concern I express above comes attached to the concern I expressed previously about HPM’s lack of recognition within the Alliance for Academic Internal Medicine. We must be visible and proactive, and we must communicate with our own Academy about existing or potential external relationships or roles we might have in other areas of organized medicine. Also, we should accept any invitations to speak at meetings such as the ACP’s and participate in leadership roles whenever possible. Sometimes to get a seat at the table you need to bring your own chair and politely elbow your way in.

And for those ACP members out there, the site below would allow you to submit a clinical skills workshop for the 2012 meeting or a presentation for the 2013 meeting:

NHPCO Management & Leadership Conference through Tweeter Eyes

I attended the NHPCO Conference and this year it was different. I’m a committed member of the tweeting subculture inspired by my twitter buddies after reading live commentary from sessions at the recent AAHPM conference in Canada.

I had not planned it before going to the conference but fell into it as I listened to the first session. My initial thoughts…..take notes in the form of tweets that I can review later. But with time and the growing joy in it, I embraced the mission to benefit to the bigger audience and resolved to tweet notes that others could follow, giving credit to the presenters & bringing the message to more people. I felt like a reporter bringing tales from the edge. I reveled at bringing the results of the Moran report to the twitter community, giving insight into the issues affecting the multigenerational hospice workforce, CMS’s recommendations about the Face to Face Visit regulations or bringing eAdvocacy strategies. It changed my conference experience completely. People around me asked what I was doing punching madly on my blackberry and became starry eyed at the thought of stardom in Twitterwood!

A highlight was meeting fellow tweeters. No introductions needed, we already know each other on a different level. I laugh as I approached them in hallways and at the bookstore “Hi!—– EOLnavigator. Great to finally meet you IRL (in real life). My real name —–Niamh!”

So what’s the point of tweeting live from a conference? Our collective mission is to get everybody passionate about end of life care with something to say about it online bringing their expertise to the masses and bringing the conference experience to non-attendees. I won’t miss another AAHPM conference & you can expect tweets on the road, not literally speaking! Read our tweets for the conference at and enter #mlc11 hashtag or follow the #hpm hashtag to meet your online hospice and palliative care brothers and sisters.

JPSM Call for QI Papers Closes April 15

The Journal of Pain and Symptom Management is pleased to announce a call for papers that report the results of Quality Improvement initiatives in palliative care.

This publication of brief reports is a joint project of the American Academy of Hospice and Palliative Medicine and the National Hospice and Palliative Care Organization. Papers focusing on hospice and palliative care settings are encouraged.

The Journal offers this professional forum to encourage dialogue, peer review, and dissemination in response to a growing international concern about quality care, patient safety, and the role of evidence-based medicine. Submissions should describe specific Quality Improvement projects, such as efforts to increase pain screening, encourage goals discussions, promote palliative care consults, encourage earlier hospice referrals, or support staff well-being. Submissions must describe the impact of the intervention, either in terms of change over time or relative to a comparator.

Papers will be considered Brief Reports and must include the following:

1) A structured abstract of <150 words with five headings: Background, Measures, Intervention, Outcomes, Conclusions/Lessons Learned.

2) Five sections—Background, Measures, Intervention, Outcomes, Conclusions/Lessons learned—requiring no more than 1,250 words

3) No more than 10 references and two graphs or tables. (References/tables/ graphs are not included in the word count.)

4) A cover letter specifying that the Brief Report is being submitted in response to this Call for Papers.

Papers that fulfill the length and formatting requirements will undergo preliminary review by the Editors, and some will undergo external peer review. Acceptance for publication will depend on evaluation of the problem addressed, innovation, quality of the description, and clinical relevance of the intervention and outcomes.

Manuscripts submitted in response to this announcement should be submitted online to the Journal of Pain and Symptom Management ( by April 15, 2011.

For questions regarding format or content of potential manuscripts, please contact Dr. David Casarett (

Appreciating Our Volunteers

Last week, President Obama declared April 10-16 National Volunteer Appreciation Week (April 10-16, 2011). In the proclamation, he states:

America’s story has been marked by the service of volunteers. Generations of selfless individuals from all walks of life have served each other and our Nation, each person dedicated to making tomorrow better than today. They exemplify the quintessential American idea that we can change things, make things better, and solve problems when we work together.

On behalf of the American Academy of Hospice and Palliative Medicine (AAHPM), I would like to thank all of our members who share their time and talent with our Academy – and those that volunteer time to assist our members in the care of patients, families and communities.

Thank you for all that you do!

Steve Smith, CAE

Executive Director & CEO

American Academy of Hospice and Palliative Medicine