For those of us who take care of aging, increasingly frail patients, the office visits can be very difficult. These encounters invariably last longer than the time allotted. The patient’s needs are often crescendoing with each visit. Symptoms proliferate and medication management gets more complicated. Family members and caregivers need more time and communication about myriad concerns. Talking with everyone involved about realistic expectations and what kinds of interventions may or may not be appropriate can be time-consuming and energy-draining.
Fortunately, help is now available in the form of Palliative Medicine. As of March 1, 2013, PHC covers Palliative Medicine consultations for our members. No prior authorization or RAF is required. Palliative Medicine is a fairly new medical specialty, but is now officially recognized by the American Board of Medical Specialties. Board certification is available in this field and is required by PHC. There are a total of eight palliative care physicians in our network currently, and one is available near you.
What exactly is palliative care, you may ask. Good question. Palliative Medicine specialists have extensive training in managing the many issues which come up as patients approach the end of their lives. They are expert in addressing the very issues mentioned in the first paragraph above – symptom management, family and caregiver support, referrals to appropriate community resources, mental health issues, discussing end of life realities. Palliative care specialists are also adept in coordinating with primary care physicians as they manage these challenging patients.
But palliative care specialists will only be helpful to you if you keep them in mind, and refer appropriate patients to them. Since it is a new field, it can take time to incorporate this specialty into one’s work flow. As time goes by, their usefulness will undoubtedly become more widely known and appreciated.
So, the next time you find yourself spending a lot of time with a frail, declining patient, and realize you’re not able to meet all their increasing needs in their outpatient appointment slot, consider referring that patient to palliative care. Have your office staff contact your PHC Provider Relations representative to get the name and contact information for a Palliative Medicine specialist near you.
Richard Fleming, MD