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Patil Is Your Pall's avatar

Palliative care physician here. Well said. I work on the inpatient side, and by the time I am consulted it is usually close to the end of life. So I am talking a lot about hospice since that is my recommendation at that time, adding to the confusion between palliative care and hospice. Hopefully there can be more education among medical staff to get us involved earlier in the disease process. Thanks for sharing this.

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Michael Richman MD, MMM, FACS's avatar

Thanks for your kind words. The truth is that I don’t think most physicians know the difference. Furthermore, I don’t even think the majority of the population even understands that palliative care is a recognized medical specialty. I wish more people would take advantage of palliative care before it becomes end-of-life because you guys do an amazing job for patients and their families.

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Judith Kyle's avatar

As a nurse I have seen healthcare organizations tell persons that they qualify for palliative care or convince relatives that palliative care is appropriate but when they sign on the dotted line all treatment is stopped, frequently the patient is not given appropriate choices regarding care. Nutrition and hydration as well as antibiotics are withheld under palliative care. Treatment of any type is withheld. You need to advise patients AND physicians of the difference. Neither one should be another word for euthanasia.

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Michael Richman MD, MMM, FACS's avatar

Agreed

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Jamie Butts's avatar

Thank you for writing about this. Often people equate the two and then pass on palliative, a wonderful service that can really enhance quality of life. You are doing all of us a great service!!!

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Michael Richman MD, MMM, FACS's avatar

Thank you Jamie-I appreciate your kindness. I figured today was a day where a lot of tough conversations are being made among family members for the well-being of another loved one so I thought the article would be timely.

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Mick Skolnick, MD's avatar

Thank you for this article. I've linked to it in an update of my post:

https://drmick.substack.com/p/a-tale-of-two-prognoses

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Sue Umpleby's avatar

I have been primary care for 2 men (black widow) I believe giving someone the dignity of choice is so important life without dignity is not life...my opinion and experience...I believe we need more emotional support for the ones whose responsibility it was to carry out the last wishes. And what it is like after their loved one passses. It is not easy to allow someone to die. Grief brings out all sorts of reactions that the "caretaker" has to experience from others. I have talked to many in this situation and it is hard. Anger is a normal response in grief but the caretakers seem to have to deal with others grief and their own. Usually by the time someone passes most people have disappeared. Not everything is a storybook.

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