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I am a Family Physician and Hospitalist and have attended patients in hospice care throughout my career. I am aware that some physicians are reluctant to make hospice referrals, and many patients and families are reluctant to accept or even consider hospice services, because of the issue of "giving up hope". Eligibility requirements for the Medicare Hospice Benefit include a prognosis of less than 6 months and forgoing any curative care. Giving a prognosis is always a guess and doctors are loath to underestimate. Often, patients have severe untreated symptoms, but are not through with curative care. To address the needs of these individuals, hospitals across the country are developing "Palliative Care" programs.

The idea behind palliative care is to use hospice style focus on relief of symptoms and maintaining quality of life, but extend that philosophy to all seriously ill people, not only those who are dying. We are in the process of developing such a program at Silverton Hospital. Ann Jackson stated on the program that "There is no excuse for anyone dying in pain." I hope to see a society that recognizes "There is no excuse for anyone living in pain (or intractable nausea, anxiety, etc.)"

posted 5 years, 2 months ago
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