State of Palliative Care

A few recent items highlighting the state of palliative care in the United States.

• This National Cancer Institute Bulletin focuses on a palliative care training program at Virginia Commonwealth University:
  

  The existence of such a training program is one small step in the evolution of palliative care. The growth and changes in palliative care are particularly significant for oncology, where an aging population and a corresponding increase in cancer incidence are expected to expand the need for palliative services. Now a recognized medical subspecialty whose value and importance have been endorsed by the Institute of Medicine and World Health Organization, palliative care has been shown to improve patient outcomes such as symptoms and quality of life, as well as patient and family satisfaction with care. The largest study of its kind, published last year, also demonstrated it can lead to significant cost savings by, among other things, decreasing intensive care unit visits.

• While at the recent PAINWeek®2009 conference, a survey of several hundred physicians was released showing the need for more palliative care mentorship:
  

  The results of the survey validated the need for a pain mentorship approach to pain management education. The survey revealed that 47% of physicians did not receive formal training about pain and palliative care in their professional education; 64% said that they see the greatest need for a mentoring program is in outpatient (office-based) practice; 46% said that they would request a mentor if this program were to become available; and 42% said they would serve as a mentor.

• CA: A Cancer Journal for Clinicians also recently published an article, "Current Status of Palliative Care—Clinical Implementation, Education, and Research," which urges clinicians to overcome barriers to palliative care:
  

  Care for cancer patients with serious and life-threatening illness and for their families needs improvement. Untreated physical symptoms, poor communication between providers and patients, and treatment decisions in conflict with patient and family preferences characterize the current standard of health care for our sickest and most vulnerable patients. The field of palliative care was developed in direct response to the unmet needs and wishes of patients and their families, and the accomplishments of this interdisciplinary specialty over the past decade have been remarkable. Nonetheless, serious barriers to palliative and end-of-life care implementation remain.
  
  Clinicians are urged to learn more about palliative care in order to overcome some of these barriers. Clinicians cannot practice what they do not know, and, therefore, attending local and national presentations on palliative care to increase their knowledge is an essential initial step. This can occur through local presentations, national meetings, online courses, and individual reading and exploration.