I loved this carton as a kid. The clearly crooked rocket that would probably blow-up. Yet it is only at this late point in the process that they start to lose faith and accept the reality that they are not rocket scientists. I was always interested in science and thought I might want to be a scientist someday. Ultimately, I became a physician specializing in palliative care. I often think, “This isn’t rocket science!”
Recently, a new colleague not in palliative care observed our Interdisciplinary Team (IDT) and marveled at how well we collaborated, solved problems, put the patient first and didn’t hurt each other feelings. Why should this be that remarkable? Unfortunately, it is. Later that month a patient’s family wrote the Chief of the University Hospital about how nice the palliative care team had been and how helpful we were. Mostly, we had listened and heard their concerns.
Today I had a phone call with our research team. For more than 10 years we have worked on ways to implement programs in hospitals so that care for the imminently dying would be more like the kind, supportive care people get with home hospice. By that we mean, that pain medications were ordered and available and the family could be present and supported and that we would stop doing things that were painful. Like drawing blood test when the result could/would not change what we were doing. This has been amazingly hard work. Not Rocket Science.
There is a great article called “A Research Agenda for High-Value Palliative Care” by Courtwright et al published in the Annals of Internal Medicine. The thesis is that there are not enough palliative care providers and we should be looking for the best ways to use those limited resources. Provide palliative care to the right patients, at the right time, in the right way and in the right place. These questions are critically important and I encourage you to read the article.
On the other hand we also need to train more providers and integrate palliative care into primary and specialty care. After all it isn’t rocket science.