Palliative Care Centers in the U.S.: Emergence, Lessons Learned and Advice from Pioneers
Randy Curtis, MD MPH was a medical student at Johns Hopkins School of Medicine in the late 1980s, a time when the AIDS epidemic was hitting Baltimore in a big way. “We were caring for a lot of young men who were being hospitalized and dying from a disease we barely understood,” recalls Dr. Curtis.
As fear of the epidemic spread across the country, the nation’s medical providers were charged with helping a staggering number of patients through painful deaths in hospitals. And those patient experiences, Dr. Curtis says, varied widely. “I had repeated experiences where on the one hand a patient dying in the hospital felt very supported,” he remembers. “But then for a patient in the room next door, tended to by the same doctors and nurses, the end-of-life care was a disaster. I knew we could support seriously ill people and do it well, but it was more common that we didn’t.”
A decade later, Dr. Curtis went to the University of Washington to further his training, first as a resident in internal medicine and then as a fellow in pulmonary and critical care medicine. There he witnessed a similar pattern of care for patients with serious illness. “I kept feeling that there was an opportunity to do serious illness care well, to educate clinicians, and build palliative care services to provide additional support for patients and their families,” says Dr. Curtis.
Importantly, many of the fundamental resources already existed within the university to deliver patient-centered and family-oriented serious illness care. “For decades, there had been pockets of excellence in palliative care around the University of Washington,” he says. “They just weren’t connected”.