AAHPM Visionary: Thomas J. Smith, MD FACP FASCO FAAHPM

Professor of Oncology; Harry J. Duffey Family Professor of Palliative Medicine; Director of Palliative Medicine, John Hopkins Medical Institute, MD 

Who has most influenced your work and what impact has he or she had?
Dr. Galen Wampler, my first oncology attending. He insisted that oncologists should be like family practice doctors and know their patients and their families, be honest with them, and treat their symptoms. Not just treat the cancer. Galen was a long bearded Mennonite who rarely spoke, but he loved his patients and they loved him. He was also the premier clinical trialist at MCV-VCU who taught me that symptoms and communication were fair game for trials. We were doing sublingual buprenorphine trials in 1985!

About the same time, Kathy Foley published her first NEJM article on the treatment of pain. Although I would not meet her for some years, she became my visionary mentor-at-a-distance. When I finally met her at the Project in Death in America Faculty Scholars meeting, it was like a dream come true. I knew lots of great oncologists, but few great symptom managers and even fewer “truth-tellers.” Now, palliative care is well integrated into oncology, and a growing number of other areas of nursing and medicine.

What does it mean to you to be named a Visionary in Hospice and Palliative Medicine?
For me, it is most special to be nominated by Patrick Coyne RN MSN, himself a visionary, and my partner for many years at Virginia Commonwealth University Thomas Palliative Care Center. We really grew up together in this field, from working in Tanzania to starting the program at VCU, then the CAPC Palliative Care Leadership Center, then the Virginia Initiative in Palliative Care. Being a visionary provides another layer of recognition that I appreciate at this stage in my career, when I am most interested in helping others advance theirs – and the science and practice of palliative care.

What is your vision for the future of Hospice and Palliative Medicine?
I am hopeful that the field will continue to grow based on more and more data showing that having a team help take care of you and your family, along with your primary treatment team for the disease, makes good sense. Who can argue with having a second pair of eyes, ears and hands help take care of complicated people, especially when their first team is stressed for time, and may lack communication and specialty palliative care skills? And, we absolutely must teach primary palliative care skills to all who will listen.

My secret hope is that we will take control of the science of symptoms and symptom management, and that palliative care people will be publishing in Science, Nature, Lancet and the NEJM! There are just so many breathtaking breakthroughs in our understanding now and in the immediate future that we must remain committed to finding good scientific, evidence-based answers. And I would love to see this part of our effort grow alongside further integration and continuation of patient and family centered care.

Thomas J. Smith, MD FACP FASCO FAAHPM is one of 30 individuals who have been named a Visionary in Hospice and Palliative Medicine by AAHPM for their 30th Anniversary in 2018. Learn more about the Visionary recognition and view a list of all current and past Visionaries.

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