According to physician leaders of the American Academy of Hospice and Palliative Medicine (AAHPM),
Congress can take steps to help build a health care workforce more closely aligned with the needs of America’s aging population by passing the Palliative Care and Hospice Education and Training Act (PCHETA).
Members of the AAHPM Public Policy Committee—including Chattanooga native and owner of Hearth Hospice, Dr. Deanna Duncan—were flown to Washington, D.C. this summer to meet with their representatives in Congress and encourage them to cosponsor PCHETA, which was introduced July 19 by Senator Ron Wyden, D-Ore. (S.3407) and Rep. Eliot Engel, D-NY (H.R. 6155). PCHETA aims to address the large gap between the number of health care professionals with palliative care training and the number required to meet the needs of the expanding population of seriously ill patients
The need for this specialized care is escalating as the population ages and an increasing number of people are living with serious, complex and chronic illness. More than 40 million Americans are 65 years of age or older, and that number is expected to skyrocket to 72 million by 2030. Palliative care focuses on improving a patient’s quality of life by managing pain and other distressing symptoms of a serious illness, and hospice provides this care for patients in the last year of life. In practice, this involves detailed and skilled communication with patients and families to create goals and determine preferences, as well as expert assessment and management of physical, psychological and other sources of suffering across the multiple settings that patients traverse through the course of a serious illness.
Dr. Duncan spent time educating her lawmakers on these points, including a face-to-face meeting with Tennessee 4th Congressional District Representative Scott DesJarlais.
“Our meetings on the Hill were very productive,” said Dr. Duncan. “It’s always rewarding to educate folks about how hospice and palliative care helps patients and families, improves quality of life and quality of care and – when patients get the care they want – saves our health care system money. I think Congressman DesJarlais, because he’s a physician himself, really understood the value in that. He gets it.”
Palliative care is a relatively new medical specialty and is often thought of as end-of-life care, or hospice care, which is a specific type of palliative care. In fact, palliative care is beneficial for people of any age facing serious illness- such as cancer, congestive heart failure, chronic obstructive pulmonary disease (COPD) , kidney disease, Alzheimer’s disease and AIDS - and can be provided at any stage of illness and along with curative or life-prolonging treatment. Palliative care physicians, nurses and other skilled professionals work as part of the patient’s medical team.
“A growing body of medical research has documented the benefits of high-quality palliative and hospice care for patients and families, for hospitals and payers, and for the health care system as a whole," said AAHPM President Timothy E. Quill, MD FAAHPM, director of the palliative care program at the University of Rochester Medical Center. “Palliative care is associated with enhanced quality of life for patients, higher rates of patient and family satisfaction with medical care, reduced hospital expenditures and lengths of stay, and other positive outcomes – including longer patient survival time. However, delivery of high-quality palliative and hospice care cannot take place without a sufficient number of health care professionals with appropriate training and skills.”
AAHPM estimates 6,000+ full time equivalents – or 8,000 to 10,000 physicians – are required to meet current needs in hospice and palliative care programs. At maximum capacity, today’s training programs would produce roughly 4,600 new hospice and palliative medicine certified physicians over the next 20 years. PCHETA would address the workforce shortage among physicians and other palliative care providers through a focus on:
- Education centers to expand interdisciplinary training in palliative and hospice care;
- Training physicians who plan to teach palliative medicine and fellowships to encourage re-training for mid-career physicians; and
- Academic career awards and career incentive awards to support physicians and other health care providers who provide palliative and hospice care training.
Leading organizations such as the American Cancer Society Cancer Action Network, the American Geriatrics Society, the Center for Advance Palliative Care, Hospice and Palliative Nurses Association, National Association of Social Workers, National Hospice and Palliative Care Organization and the National Palliative Care Research Center have voiced support for PCHETA and are working to build awareness and support of the bill.