Two ways to enhance palliative care

According to this groundbreaking research article from the physicians at MD Anderson, we can enhance palliative care in two key ways: 1- Having "a system in place to trigger a referral when patients meet criteria..." 2- Providing outpatient palliative care resources that "deliver personalized, timely patient-centered care..." Fittingly, my new book, The Journey's End, comes to the same conclusions. In fact, one of its key themes is that we need to reform the healthcare payment model and re-focus on end-of-life care in medical education. If you're interested, my book provides a road map for implementing such changes.

Coding hampers physician-patient communications that enhance care

Med students need better communication skills, and this training program in Massachusetts shows why: 1. “Studies have shown that patients who have [substantive] conversations with clinicians are...more likely to receive care and experience better quality of life.” 2. “With a national shortage of [physicians] to care for an aging population, it is mandatory to find innovative solutions to train all physicians in effective high-quality communication for seriously ill patients.” So why don't physicians devote time to these types of conversations? And why do we have such a shortage of physicians for aged patients? The simple answer is that the billing and coding system does not incentivize these conversations. It is basic economics. My book, The Journey’s End, provides a detailed analysis of these issues, along with pragmatic solutions to remedy them.

How to ease access to palliative care

Palliative care is increasingly recognized as a vital patient care treatment model. Unfortunately, we created a new specialty but forgot to create an insurance mechanism to pay for it. Access to palliative care as a result, is limited and nonexistent for outpatient care.

This article highlights the need for providing insurance compensation for this critical patient care service. While this observation is an important one, the proposed solution is overly complex.

We should make access to palliative care easy and encourage its use. All palliative care should be deemed medically necessary and not subject to the absurd coding requirements.

In my book, The Journey’s End, I provide a detailed reform recommendation to make palliative care easily accessible without coding.