Monday, November 26, 2007

AAHPM Pre-Conference Preview Part 1 (AAHPM Sessions)

Early this year I posted a preview section for the AAHPM/HPNA conference in Salt Lake City. Of course last year when I decided to post it, it was too late for people to people to change their registered pre-conferences, so this year I am going to cover the pre-conferences early enough to give you some thoughts on what might interest you. Today, I highlight the AAHPM pre-cons, later the HPNA pre-cons.

I started doing the preview because one of my favorite things about conferences is talking to other people to see what they are interested in, so feel free to tell us what you are going to and why. If you are giving any of these talks, I encourage you to leave some comments to get more people aware of your talk. There are some good ones!

Wednesday January 30th, 2008
8am-Noon


Hospice Medical Director Course Module B - Regulatory Issues

The AAHPM includes this as part of a series (A,B,C) with the other sessions usually taught at Current Concepts or other times throughout the year. Since I completed a palliative medicine fellowship, I have not seen the need to go to this, although there may be some tips to be picked up here. I have not heard anyone ever rave about the regulatory module (YAWN! (but important if any Medicare officials are reading this blog!)) , but I think that is probably due to the nature of having an important foundation in hospice regulations if you plan on being a hospice medical director. Regulations...you gotta know them, you may not like them, you may think they don't make sense, but they are here to stay. Until they change next year.

Quality Measures for Hospice & Palliative Care

by Dy, Hanson, Asch, Wenger, Walling

To me quality indicators are just a little more exciting then regulatory issues. So my review will be biased a certain direction. (I would be happy to hear form any self-described policy afficianados, who want to comment on the importance of these and advocate for more people going to this session.) A lot of important work went into creating these standards and I hope our field will be better off for applying a structure, but part of the cynic in me worries about creating an administrative framework that has minimal bearing into clinical practice. This session will talk about PEACE, ACOVE, and ASSIST, of which I am familiar with none, and also features speakers who I am not familiar with so this anemic review will end. Now. (Please enlighten if you know more about this session)

Moving Beyond "I Hate These Discussions": Gratifying Tools to Facilitate Patient and Family Decision Making Near the End of Life

by Menkin and Weiner

Ah the dreaded words 'role play' are stuck at the end of this description. But fear not! Role play should never keep you from going to a session. You should jump at the chance to ply your skills in front of people who could give some great feedback. One of my favorite things about role play is that it gives you the opportunity to mess up really bad. And often times if you do the first role play with intentionally making it a horrible horrible situation, you can highlight the obvious things that did not work and refine from there. While I am not familiar with these speakers the idea of giving structure to family decision making is a good topic for all. A theme which resonates in the pre-cons. With a structure guiding you, one is allowed improvise with more confidence as the situation changes, which is one of the most important factors to becoming a skilled clinician.

Opioid Dosing Strategies and Toxicity
by Davis, Lasheen, Walsh, LeGrand

Is it just me, or does that list not seem impressive if you leave out first names. Davis means nothing to me, unless I see Mellar in front of it, same with Walsh without the Declan, and LeGrand is unique enough to stand alone. The good folks at Cleveland Clinic return with a comprehensive opioid talk. A good one for feeling more confident in titration and conversions which is something all good palliative care practitioners should feel comfortable with. While MD based, I think this could be very beneficial for nurses as well since they often are catalysts in titrating opioids and the first line in the home at observing potential toxicities.

Discipline-Specific Leadership Skills Development
(Physician 8-Noon, SW 8a-5p, Nurse 6p-10p)

While the brochure is lacking in faculty lists and has a generic description these sessions look to be a pretty good deal for junior leaders (or soon-to-be leaders) in our field. I'll tell you that being such a new field there will be lots of room and need for leadership in the coming years at national, regional and local levels. Networking and career development sessions such as these and the more in-depth Harvard PCEP are great opportunities that compresses and shares many years of experience in just a few hours. For more info on each one, click on the link for the discipline above. These are sponsored by the College of Palliative Care and have NO FEE!! Thanks CPC!

1-5pm

Essential Grant Writing Skills for Junior Investigators
by Casarett, Ferrell, Tulsky, Kramer, Bakos

Also a NO FEE talk, this talk is a similar theme to pre-cons in the past few years. We got to build our research base people! Hopefully many will get inspired and do some great non-observational research (i.e. RCT's and treatment trials). I found this talk very helpful/inspirational in the past, but the one thing this talk will likely not get you is an infrastructure to do research, so hopefully you already have one in place, because you won't learn how to make you community hospice into a research institute in the next 24 months. Great speakers by the way and always nice to have Alexis Bakos from the NIH to help get us the inside scoop.

Mediating Ethical Dilemmas
at the End of Life
by Williams and Arnold

While no class on ethics will ever tell you the answer to every ethical dilemma you have encountered, having a structural framework that is clinically applicable and teachable (as this session promises) is a great tool for our field. I am not sure what a MB ChB is, but Charlotte Williams, MBchB from UAB joins Bob Arnold for what looks to be a new and invigorating addition to the pre-cons.

"Is There Something I Should Know About Your Beliefs that Will Help Me in Your Care?" Talking to Patients About Their Beliefs and Spiritual Concerns
by Pulchalski, Blatt, Lunsford, Baird

FICA is your friend. No really. This is a great tool, and this session will highlight this tool and other strategies and themes. I have not yet had the pleasure to hear Christine Puchalski speak, but I have heard good things about her sessions in the past. This session should be a good one, and if you think you know FICA, they will likely expand your understanding and flexibility in approaching this powerful subject. I just hope the session has a wide audience and attracts more than just the choir (sorry) so that some people become more comfortable about spirituality and medicine.

Alternatives to Oral Opioid Therapy for Refractory Pain Conditions
by Yellig, Fine, Panchal

In under 4 hours, this session will cover some very interesting areas, such as ketamine, and interventional pain techniques. I find these sessions very intellectually stimulating but I shortly after being inspired at the session, I realize all the work I may have to do once I am back in my local environs to ally with the interventionalists or get staff more familiar with ketamine for pain control. I would like to see more appropriate and early access to nerve blocks and the like in our field, but I worry if our field will start to subspecialize even more.

Overheard conversation at AAHPM/HPNA in 2015:
Sue: "Hi! I'm a Spiritual Palliativist."
Tom: "Nice to meet you. I am an Interventional Palliativist. Have you met Joe? He is our new Conversational Palliativist."
Sorry that became more of an editorial. Final verdict: looks like a good session.

I will review the HPNA pre-cons in the next couple of days. And I am by far not the final word on any of these. Pick what interests you and feel free to offer comments about why you are going to any of the above session.


  • Interesting Quote of the Month with Palliative Care Influences:
    “Life is not what we experience, it is what we remember and how we remember in order to retell it.” - Gabriel Garcia Marquez, Living to Tell The Tale
  • Pallimed represent! I (Christian) will be at the Cachexia Conference in Tampa next week. I will have a Pallimed sticker on my badge, so feel free to come say hi if you see me, or post a comment or email me if you are going to be there and want to got to a Tampa Bay Lightning game Thursday night. I plan to report back from the conference to tell all Pallimed readers how to defeat cachexia!
  • Edwin Leap, MD reflects on witnessing the impact of death in the ED, and how it seems like an alternate universe when he comes home to his family. I think this is something that could be echoed loudly by our field. Seeing death on a regular basis in our work makes little things in life much more valuable. It would be great to see some more palliative care oriented blogs to balance out the ED ones. (via Kevin MD)

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