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A Physician Shares his Thoughts on Palliative Care


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A Physician Shares his Thoughts on Palliative Care

Sunday December 7, 2008

Bob Wachter, a physician and blogger, published a blog on his site Wachters World with an interesting title, "My Patients are Dying...and I've Never Been Prouder". In this post, he shares why he is so proud of the palliative care staff at UCSF, and of himself, for helping patients and their families through end-of-life decision making and through death. Some highlights from his post:

The movement promoting compassionate care for dying patients was largely community-based and tended to focus on patients dying slow and painful deaths – mostly those with terminal cancer. Meanwhile, in the hospital we were exploring the senselessness of “doing everything” for (or, more to the point, to) patients with poor prognoses, troubled by seeing lives end so violently, stripped of all dignity. But we spent virtually no time thinking about how to bring hospice-like sensibilities and resources into the hospital. Frankly, as I think back, many of us saw that work as being a bit too touchy-feely for our tastes. We were doctors, after all, not social workers...

But the larger tragedy of our failure to embrace palliative care as a legitimate discipline was that by continuing to view death as a failure, we failed to gain the expertise and garner the resources to promote affirmative conversations with patients about alternatives to aggressive care. Sure, we might close the curtains, bump the morphine, and allow the patient whose care was near hopeless to pass peacefully, but we virtually never spoke openly with patients or families about how a focus on comfort might be a better way to complete one’s life...

I couldn’t be prouder of the way we managed the patients’ care, our communication with the patients and their families, and the tears that we’ve all shed along the way. At one point or another in virtually every case, family members hugged me, members of my team, or members of the PCS and thanked us for our wonderful care – this at the most horrible time in their lives. It is uniquely sobering and gratifying.

Well said Dr. Wachter.

Please read Dr. Wachter's article in it's entirety. He does a wonderful job of illustrating the necessity of hospital-based palliative care programs.

http://www.the-hospitalist.org/blogs/wa ... ouder.aspx

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