Palliative Care Is the Job of Every Hospital

Diane E. Meier, MD, FACP


July 06, 2007


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Advances in modern medicine have resulted in unprecedented gains in human longevity. But the fact is that eventually most adults will develop chronic illnesses with which they may live for years. Research indicates that for most people, advanced disease is characterized by big trouble: inadequately treated symptoms[1,2,3,4,5,6,7]; fragmented care systems; poor communication among physicians, patients, and families[8,9]; and enormous strains on family caregivers.[10,11,12,13]

An artificial dichotomy still exists in the very fabric of our healthcare system -- cure vs comfort. This dichotomy ignores the fact that the overwhelming majority of people living with advanced illness require both life-prolonging and palliative treatments. Forcing a choice between cure and comfort until the end-of-life predictably results in preventable suffering during all other stages of a serious illness.[14,15]

Palliative care is the medical specialty that provides interdisciplinary care focused on relief of suffering. Non-hospice palliative care is offered at any point in a serious illness, along with life-prolonging treatments. It is not dependent upon prognosis.

In recent years, hospital-based palliative care programs have grown rapidly in number, increasing from almost none to 50% of all hospitals over 75 beds.[16,17,18,19] This is the good news. The bad news is that it is only 50%.[16] To meet quality standards, and to provide the best care for their most seriously ill patients, every hospital must install a palliative care team that provides both hospice and non-hospice palliative care.

We all must therefore press hospitals to provide palliative care programs that meet National Quality Forum[20] guidelines staffing them with properly trained professionals. Hospitals will benefit from increased patient satisfaction and decreased length-of-stay.[21] Patients and families will benefit from increased satisfaction and higher quality care.

Given the evolving demographics of our aging population,[22] hospital palliative care programs are a necessity, not an option.

That's my opinion. I'm Dr. Diane Meier, Director of the Center to Advance Palliative Care at the Mount Sinai School of Medicine.




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