What is palliative medicine?

In the last 50 years, medicine has focused successfully on the cure and long-term management of many diseases. That in itself is wonderful since we all want our doctor to make a serious illness go away or turn it into a chronic disease that will allow us to continue our lives as normal as possible.

However, all of us are going to die at some point. In most cases we will die of a serious chronic disease that will cause severe distress. Even when the disease can be cured, we may still suffer physical and emotional difficulties.

Palliative medicine was originally developed in the United Kingdom and Canada and is currently a medical subspecialty in the United States. The focus of palliative medicine specialists is to relieve physical and psychosocial suffering in persons with a serious illness and to support their significant others.

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Teams that specialize in palliative medicine include a physician specialist accompanied by specially trained nurses, counselors, chaplains, pharmacists, and rehabilitation clinicians. They deliver care in outpatient centers frequently known as supportive care centers, in consult with teams for patients admitted to the hospital, and in palliative care units for those inpatients and families with the highest level of distress.

Palliative medicine relieves suffering in patients and families and allows them to leave the hospital and continue feeling better once at home. There is strong evidence that palliative care teams dramatically reduce the cost of medical care for patients, hospitals, and insurers.

Unfortunately, medical schools and large hospitals in the United States have been very slow to adopt palliative medicine. There are too few supportive care outpatient centers and palliative care units, even in hospitals where hundreds of patients die every year. Medical schools have limited palliative medicine content in the educational curriculum for both undergraduate and graduate training as compared to most others specialties. There are also too few teams conducting research on the most effective ways of delivering palliative medicine.

It is important to develop structures and processes so we can provide our patients and relatives access to this excellent level of care integrated with the care they get from their primary specialist. These structures also expose students and junior professionals to this important field of medicine.

-By Dr. Eduardo Bruera, department chair, Palliative Care and Rehabilitation Medicine at MD Anderson Cancer Center and panelist for the upcoming “Let Me Down Easy” performance and discussion

PolicyWise is discussing topics relating to medical decision making that will be featured in the Jan. 17 performance of Let Me Down Easy by Anna Deavere Smith. Tickets can be purchased online for the performance only or the VIP dinner package, which includes a facilitated dinner discussion with audience members.

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