Emergency medicine physicians often see patients with advanced and end-stage disease. Once in the hospital acute care setting, the patient’s objectives and goals may be in direct contrast to the strategies of life-prolonging treatment.
Training in palliative care in the emergency department increasingly is being recognized as important in providing the best care to these patients.
“The purpose of palliative training for Emergency Medicine physicians is to better prevent and relieve the suffering experienced by patients with life-limiting illnesses, as well match patient and family goals of care with care delivered,” says Michelle Rhodes, MD, assistant professor of emergency and palliative medicine at the University of Arizona.
Dr. Rhodes is one of only a few emergency medicine physicians in the country to receive fellowship training and board certification in palliative medicine. She also serves as the assistant director of the UA Department of Emergency Medicine Hospice and Palliative Medicine Fellowship, a new partnership with the Department of Medicine Division of Geriatrics, General Medicine and Palliative Medicine.
Fellows train with a palliative medicine team of experts from internal medicine, critical care medicine, psychiatry, oncology, anesthesia/pain, emergency medicine, surgery and trauma, social work and the chaplaincy at Banner – University Medical Center Tucson, the Southern Arizona VA Health Care System, Tucson Medical Center and community hospices. Fellows learn to maximize quality of life using a team-based approach, while addressing the physical, psychological, social and spiritual needs of both patient and family.
“Our aim is to integrate palliative care seamlessly with emergency medical care by teaching the skills for pain and symptom management, communicating skills and reasons for formal palliative consult, said Dr. Rhodes.
“As the front door to the hospital for a large number of these patients, we set the trajectory for their care. It is vital to make sure symptoms are controlled to the best of our ability, and most importantly, that we are providing care consistent with patient and family goals.”