Every mechanic knows how to change a car’s oil and rotate its tires. On the other hand, it takes special training to fix problems with some of the more complex or newer technologies, like hybrid drive systems.
By the same token, every doctor knows how to take care of the basics, like checking blood pressure, but specialists are needed to do more complicated things like heart catheterizations.
Palliative care works the same way…every doctor, every nurse, and every person in health care needs to understand the basics of good symptom management, routine advance care planning and goals of care discussions, and coordination of care. Palliative care specialists deal with the more complex situations, like discussions about withdrawal of life-sustaining therapies, or complex decision-making, etc.
What is palliative care?
Palliative care is specialized medical care for people with serious illness. It ensures that patient and family needs are being met, and that the quality of their life is maximized. It provides an extra layer of support, and is appropriate at any age, and any stage in a patient’s illness, and can be provided together with curative treatment.
How is primary palliative care different?
Primary palliative care is an integral part of good patient care. It is what ALL providers try to do for their patients. It includes keeping patients and families informed, as well as symptom management, family meetings, code status discussions, informed consent, and care of the seriously ill or dying patient.
Like blood pressure treatment, or heart disease treatment, we want every doctor to know the basics, and be able to manage these things to their best ability. Everyone deserves good palliative care from their doctor, like everyone deserves primary care from their family doctor.
How about specialist palliative care?
As complex as health care now is, specialist palliative care physicians and other team members are available in many settings. They can help with the more difficult conversations, complex family dynamics, difficult to control symptoms, family conflicts about care goals, distress regarding decision-making, and providing the overall “big picture” of care.
Sometimes you need one, sometimes you need the other
Like any area of medicine, palliative care is ever evolving. Many hospitals and health systems are developing and providing education to their doctors on primary palliative care, as a commitment to excellence in patient care.
There aren’t enough cardiologists around to manage every patient with high blood pressure, and there aren’t enough palliative care specialists to manage every patient with serious illness.
Sometimes, you need a primary care doctor, and sometimes you need a specialist. But everyone deserves the best care possible, including discussions, information, goals of care, and symptom management.