UW News

October 6, 2009

Pacific Northwest doctors gain more options for end-of-life care training

Center for Sensorimotor Neural Engineering

While end-of-life-care issues have come front and center in the current health care reform debate, physicians in the Pacific Northwest now have access to intensive training and new board certification in palliative medicine and hospice care.

The new University of Washington Palliative Medicine Fellowship Program, the first of its kind in the state, is a cooperative effort between Providence Hospice of Seattle and the UW School of Medicine. Providence is providing funding to help launch and sustain the UW program. The first physician began training in the program in July 2009. Four others will begin the intensive year-long program in July 2010.

Hospice and palliative medicine is a relatively new medical subspecialty to receive accreditation. The American Board of Medical Specialties and the Accreditation Council for Graduate Medical Education first announced formal endorsement of hospice and palliative medicine as a medical subspecialty in October 2006. The board offered the first certification exam in November of last year. Since then, more than 50 similar palliative medicine fellowship programs have been developed across the country.

In the past, certification was possible through the American Board of Hospice and Palliative Medicine, but making palliative care a subspecialty takes it to a much higher level, said Dr. Wayne McCormick, medical director of Providence Hospice of Seattle and Program Director of the UW Palliative Medicine Fellowship program.

“This will definitely help grow the area of palliative care in this region and throughout the United States,” said McCormick, a UW professor of medicine in the Division of Gerontology and Geriatric Medicine. “It’s a giant step forward in helping patients at the end of their lives – and their families too.

“Palliative care recognizes the emotional side of the human experience,” McCormick said. “It recognizes that everyone dies and that the medical community and the patients served should embrace that and find a way to make it – at least – a comfortable passage and – at best — to celebrate it as the human experience. This is a shift from where American medicine is now. This way of thinking about palliative care helps physicians address not only the physical pain at the end of life, but also the emotional suffering.”

McCormick said that while only a minority of individuals need major pain medications at the end of life, many more need significant emotional support. Physicians and hospice teams treat the dying person’s family and friends as one entity. The team helps support the family of the dying person through the various stages of grief. “The dying person may have tremendous unresolved spiritual or emotional issues with family,” McCormick said. “That’s part of the training for the fellows.”

Those enrolled in the new program must have completed a residency in a medical specialty. Palliative medicine fellows come from one of 11 medical specialties, including anesthesiology, emergency medicine, family medicine, internal medicine, obstetrics and gynecology, pediatrics, physical medicine and rehabilitation, psychiatry and neurology, surgery, and radiology. Fellows will train at local hospitals and Providence facilities. Each trainee will work for several months in a hospital setting, spend 15 percent of the time in a hospice setting, spend one month in a long-term care facility such as a nursing home, and will see palliative medicine patients in a clinic for six months.

Providence Hospice of Seattle is a part of Providence Health & Services, a not-for-profit health system committed to providing a comprehensive array of services to meet the needs of communities across five states, including Alaska, Washington, Montana, Oregon and California. Providence is committed to quality and excellence in end-of-life care and has a long history of collaboration with UW School of Medicine in medical education and the delivery of health care services. The UW has the only medical school in the five-state WWAMI Region (Washington, Wyoming, Alaska, Montana and Idaho). The school offers residency and fellowship training in 85 other specialty and subspecialty programs, and is nationally known for its high-quality medical education.

For more information about Providence, please go to www.providence.org. For more information about the University of Washington School of Medicine, please go to www.uwmedicine.washington.edu