I’m excited to be a part of the NHPCO Leadership and Management Conference in Washington, DC among colleagues who are so dedicated to the field of hospice and palliative medicine. I’m energized by the conversations in the hallways and the buzz that’s going on in the educational sessions. However, I was disappointed by the comments in Thursday’s plenary session inferring that modern palliative care has turned its back on hospice. Nothing could be further from the truth. A critical and integral component of palliative care is hospice. Many of us in the field have worked hard to help health care professionals, the public and the media understand that palliative care is appropriate for all persons living with a serious or life-threatening illness and their families. To suggest, otherwise, or to suggest that there are leaders in palliative medicine who want to remove hospice from the continuum of palliative care is inaccurate. As the President of AAHPM, I can say without hesitation that the Academy is committed to ensuring high quality palliative care in all settings – most notably hospice.
R. Sean Morrison, MD FAAHPM
President
American Academy of Hospice and Palliative Medicine
I want to add my voice to that of AAHPM’s to say that there is no palliative care without hospice and there is no hospice without palliative care. Palliative care is about matching treatment to patient goals and needs whether they have a curable disease (like leukemia or lymphoma for example), or a chronic disease (like Alzheimer’s or dialysis dependent end stage renal disease) or are living in the last few months of life. Hospice is the best thing that Medciare does and I am hopeful that one day it will be available to all, based not on someone’s estimate of their prognosis, but on need for home-centered, patient and family-centered, well-coordinated care. There is every reason to be optimistic about this as the new health reform law calls for pilots of the simultaneous hospice+life prolonging care model, not to mention coordinated care models like accountable care organizations and medical homes- neither of which have a prayer of success without palliative care and hospice expertise. So yes- hospice is a critical component of the continuum of palliative care.
We are one people! I am excited to hear palliative care leaders like Sean Morrison and Diane Meier supporting the continuum of palliative care that includes hospice. The Medicare Hospice Benefit, with all of its limitations and frailties, is still the most inclusive payment program for palliative care – and without a revenue stream, it’s tough to provide the excellent, coordinated care needed by patients with serious illness and those who care for them. As we work to ensure that our patients receive the care they need, it’s important for us to speak with one strong & confident voice.