Palliative Care

Dr. Greidanus is the lead physician on a “Serious Illness” committee at Parkview Medical Center that is looking to start a Palliative care program.  His involvement is a result of an interest in symptom management and end of life issues such as advance directives.  He has been frustrated in his work as an Emergency Physician that even those with terminal conditions have little understanding of Palliative Medicine and fail to make informed end of life choices.

Dr. Greidanus attended the UCSF (University of California, San Francisco) PCLC (Palliative Care Leadership Center) Training Program February 7-8 2013 with a team from Parkview Medical Center, Pueblo, CO.  The course was led by Dr. Steven Pantilat, Professor of Clinical Medicine, Director, Palliative Care Program and Palliative Care Leadership Center, UCSF.

Palliative care is commonly misunderstood.  It is specialized medical care for people with serious illness. This type of care is focused on providing patients with relief from the symptoms, pain, and stress of a serious illness- whatever the diagnosis.  The goal is to improve quality of life for both the patient and the family.  Palliative care is provided by a team of doctors, nurses, and other specialists who work with a patient’s other doctors to provide an extra layer of support.  Palliative care is appropriate at any age and at any stage in a serious illness, and can be provided together with curative treatment.   We reviewed the literature on Palliative Care.  One interesting study from NEJM 2010 showed that patients randomized to Palliative Care had better quality of life, improved symptoms (pain, dyspnea, nausea), less depression, fewer invasive interventions at end-of-life, and longer life by 2.7 months on average.  Another study showed that only 37% of patients with advanced cancer had discussed end of life issues.

The PCLC training program is essentially a mentorship program in which advice is given on how to establish a Hospital Palliative Care Program.  This includes discussion on systems assessment and mission alignment, clinical models and staffing, finance, internal marketing, and program implementation.  Follow up phone calls with the mentoring Palliative Care physician is scheduled for 1, 3, 6, 9 and 12 months after completion of the course.