Thursday, June 9, 2005
Comments Policy
Comments Policy: The editors of Pallimed reserve the right to remove any comments we deem offensive/hateful, mean-spirited, commercial, a potential violation of patient privacy, or in any other way inappropriate. This blog is intended to foster collegial, well-informed discussions about research and news relevant to clinicians working with patients facing severe/life-limiting diseases: it is not a forum for discussing individual cases or airing complaints or concerns about specific cases, clinicians, or institutions (whether from the clinician, patient, or family perspective). Such comments will be removed at the discretion of the Pallimed editors, and we make no apologies for maintaining an open, professional, friendly tone on Pallimed.
We welcome and encourage comments that challenge, contest, or otherwise disagree with Pallimed's content, as long as they are written in a thoughtful, constructive manner.
Patients who want to comment about their own experience are welcome to do so, as long as such comments conform to the guidelines outlined above. Personal attacks (on clinicians, other commentors, etc.) will not be tolerated - this is outside the scope of the blog's mission and intent.
The contributors to Pallimed often discuss amongst ourselves if we should delete a comment: we take our vision of balancing open discussion with maintaining a family-friendly and professional platform very seriously. What comments are likely to be deleted (besides obviously hateful or commercial or privacy-busting ones)?
- Ones which name individual patients or clinicians directly (unless it's posted by a patient her or himself, and conforms to the above guidelines)
- Ones which have a primary theme of complaining/sharing grievances about an individual case (whether from a patient, clinician, or family perspective) - we may be sympathetic but this blog is not the forum for airing such concerns.
- Ones which provide personal or individual judgments on contributors or commentors on Pallimed (e.g. rhetorically framed as 'you are immoral/depraved/wrong' as opposed to 'I disagree with what XXX said; instead I think ZZZ is a more appropriate response to this situation. Here's why.....").
- Generic, unsupported, blanket accusations/complaints leveled at anything. E.g. "People are getting killed in hospices," "Oncologists are always lying to their patients," etc. If you wish to share such sentiments, we ask that you present such complaints in an organized, well-grounded fashion, provide references, and limit yourself to things you would be comfortable saying in a public forum (not anonymously). Would you stand up in a plenary at AAHPM or another conference and make such a comment? If so, fire away!
Last revised April 2, 2011
3 Responses to “Comments Policy”
September 22, 2009
There's an interesting interactive story called A Matter of Life & Death about end-of-life care and the health care reform debate in Flyp Magazine.
November 29, 2009
As a retired hospice nurse I was always mystified by the issue of opiod tolerance. I recently opened my October issue of Scientific American and read the best summary of chronic pain research I have seen for a long, long time. I would recommend it for some new understanding into the physiology of this problem.
mary jane manion
January 13, 2010
ljsOn Intrathecal medication: Hi. I am a pain and palliative care physician in Pnoenix/Scottsdale area. I have read some of your blog after a friend emailed me. Sorry I missed the survey. I have a pain and palliative care practice, Center for Pain and Supportive Care which includes 3 pain (2 anesthesia based 1 PMR) docs and 1 Hospice and Palliative Care Doc. I also am boarded in HPC. We have a busy intrathecal practice and place around 200 pumps a year. The experience here is quite positive, decreasing costs at end of life significantly. More importantly, the integration of pain and symptom management early in disease makes end of life care an easier transition to hospice with pain and symptoms under well control. We work with many hospices but most frequently with Hospice of the Valley and Hospice of Arizona. We maintain all of our pump until end of life making home visits, hospice IPU visits, etc. Goals of care are discussed with the hospice team.
I have spoken at AAHPM now twice on intrathecal therapy. The difficulty with intrathecal therapy in malignant pain and palliative care is secondary to the time commitment. It is somewhat embarrassing to admit that my pain peers really let us down. Malignant pain is attractive to pain docs because it is a feel good avenue to go down. Unfortunately, the commitment to patient care in the face of the complexity of malignant pain often results in failure and negative impact on the therapy. I have been attempting to educate AAHPM docs on how to partner with pain physician and integrate and utilize this therapy but have not made an impact yet. While pain docs are interested, they have no long term interest in home/hospice visits, phone calls in the middle of the night or urgent clinic visits to avoid hospitalizations. We have one of the few outpatient, private, free standing palliative care clinics in the nation. We are available 24/7 and see around 20 new cancer patients a week. I have put together a "cancer pain college" which serves to integrate interventional pain, oncology and palliative medicine. My next course will likely be in August, associated with the Napa Pain Conference. We request that teams include an implanter(technician), a manager (oncology, palliative medicine, or interested pain doc), nursing or physician extender and a member of the administrative staff. We cover interventional procedures and intrathecal implantation techniques, trouble shooting, use of bolus therapies, medication algorithms, symptom management, end of life, financial stucture and office coordination of care. We also address burnout, physician fatigue and office debriefing. It is alot for a two day conference but last year we got decent feedback. I will attempt to post this but as progressive as I am about pain management I am ignorant on the technological means of the net.
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