Wednesday, January 23, 2008
Don't forget to take the 2008 Pallimed Reader Survey, if you have not already. Thanks if you are one of the 42 people who have already finished it! We appreciate the feedbackSince there is so much going on at the American Academy of Hospice & Palliative Medicine and the Hospice and Palliative Nurses Association Annual Assembly I will just cover some of the highlights of each day. How I determine what is a highlight is a secret highly objective mathematical formula, but if you want to bring notice to one of your own sessions please feel free to post a comment.
Previous posts for 2008 Annual Assembly:
AAHPM Pre-Conferences Wed Jan 30th
HPNA Pre-Conferences Wed Jan 30th
Thursday, January 31
Cancer is a Word, Not a Sentence
by Robert Buckman, MD
by Robert Buckman, MD
Author of the book by the same name (and 15 others), Dr. Buckman will be speaking about how to deal with the fear of being diagnosed with cancer. He is a medical oncologist and teaches at the University of Toronto. You can find out more information about him on his personal website. I would guess the talk will be based loosely on his book, but refined for the medical professional as opposed to the patient. He is the author of some great articles as well, notably a series of letters published in BMJ between him and a homeopath practitioner. He has been practicing since 1972 so should have a lot of experience do draw from. I would like to know how he found the time to write 16 books and numerous other articles. But I won't be there to ask the question, so if anyone else can let me know what he says.
Slatkin and Rhiner (City of Hope) will tackle topical approaches to pain originating from the skin and from mucositis. I hope they make sure to highlight the difference between systemic (transdermal) and local (topical) applications of medications, since there seems to be a cognitive dissonance with some palliativists as to how these medication routes work. Patrick Clary, MD (Exeter Hospital) has an intriguing session titled Dying for Beginners: A Palliative Physician/Poet's Stories from the Bedside. This is another session that originates from a book. For those who have argued the AAHPM has become to clinically/research oriented this is the one for you. And for the program development folks, you have the cleverly titled "Don't Ask, Don't Receive" which covers physician involvement in development and philanthropy from two esteemed speakers Rodney Tucker (UAB) and Diane Meier (Mt. Sinai).
And probably the most intriguing concurrent session for this time slot: "Can Clinicians Who Care for Adults Also Care for Children with Life-Threatening Conditions?" by 5 different speakers (in only one hour? - maybe this should be a pre-conference next year?) Hopefully all Pallimed readers know the answer is YES!, Absolutely YES! we do not have enough pediatric palliative care providers to shirk the duty of caring for pediatric patients. And while many many pediatricians will tell you that kids are not little adults, I would argue that, "Yes in fact they are!" The communication and symptom control skills once mastered can be dutifully applied to this underserved population. Until we get enough pediatric palliative care practitioners, we should all be willing to step up to help our pediatric colleagues.
One of the talks during this session is titled State of the Science for Palliative Care for Dialysis Patients by Moss (WVU). Is this an official designation a la the State of the Science lecture given by Fischberg and Goldstein every year at the end, or is the title the submitted one and an appeal to authority? I am not sure but the topic is a good one for expansion of palliative care to a underserved population. Lyckholm (VCU), and Morrison (Baylor) review Developing a Curriculum for Rotating Trainees, which would be nice for many programs to have, except it is hard to find a one size fits all approach for this, but I expect Laurie and Laura will have some good pointers.
Ending Prevention: When and How to Stop the Statin, Ignore the Blood Pressure, and Give the Patient a Cookie covers a topic that needs much more exploration in our field since there are very few research studies on withdrawal of medications and potential harm or benefit. While deciding what to stop may appear simple on the surface it requires a deft blend of medical and psychosocial knowledge to achieve well. Professional Boundaries is covered by Vig (U. Wash), Foglia (NCEHC) and Puchalski (GWU) and is an area we need to help each other in as good teams do. Cross-culturalism, Billing, and Psych meds round out the session, not all in one talk though.
My pick in this session will probably be the very popular Memento Mori in Film and Visual Arts by Matzo and Nedeljkovich (U. Oklahoma). I find these lectures that blend pop culture and medicine typically do well for many reasons: As a break for potentially monotonous speaker via likely inclusion of multimedia, applicability to use back home with colleagues, likely stimulating for discussion with peers. If I was going on Thursday, this is where you would find me.
Although there are other good sessions as well, particularly the Cytokines talk by the MD Anderson folks, although the applicability to everyday practice may be lacking, it is good for the field to recognize this type of pioneering basic research to back up our field. Schonwetter and his colleagues at LifePath will be highlighting their efforts to build Community/University Partnerships which will lead to better and more applicable research in hospice organizations. This would be my second pick, as it is something I am working on myself right now. Other talks covered during this session are Evidence Based Care, more Cultural issues, and a focused session on Parkinson's. And of course a congratulations to Russ Portenoy for receiving the PDIA Palliative Medicine Leadership Award. He will also be speaking during this time.
We have our winner for first repetitive use of title: Methadone: The Good, The Bad, and The Ugly. It doesn't happen every year and is of course no fault of the presenters, but hopefully in the future duplicates may get straightened out so all the titles don't become too cliche. Of course if the title is well-integrated into the talk it may be more difficult to change titles so quickly. Picking a title is an important skill in submitting a talk, which I will review more on submissions for talks sometime in the Spring. But seriously, Loitman (Wash U) and Gazelle (Harvard) should do great in helping to learn about the peculiarities of methadone is important, particularly with the recent reports of increasing deaths secondary to methadone.
Interventional Radiology for Symptom Control by Gershon, Ninan, and Singh (MD Anderson) should be good as a primer in the various ways that palliative care can be very helpful but not necessarily cheap. A good argument for not basing the whole financial reason for your service as a a potential cost reducer. Palliative care is not always cheap on the technology or the pocket book. Faith Hospice and Alive Hospice send Dr. Mulder and Dr. Bridges to update our field on the Impact of Open Access Policy on Hospice Length of Stay and Cost per Patient Day. The advocates for Open Access seem to have quieted down from a few years ago, and I wonder if it is because they found a model that works and don't want to share it, or if Open Access is a strategy that cannot be supported under the current (or future) reimbursement mechanisms. I sound too cynical either way, don't ?. I hope they have some good new to report. And my Kansas City colleague Jesse Roberts, MD from NorthCare Hospice & Palliative Care will be presenting data from their 5 year foray into specialized Cardiac Hospice. They have done a good job with it and other hospices will want to see if it is a formula they may be able to emulate in their area. Data Analysis, and Communication topics round out the session as well as another PDIA Leadership Award, this time to Terry Gutgsell, MD from the Cleveland Clinic.
That evening after the Poster Session and Job Fair (Go see Drew!) and the SIG meetings is the AAHPM Music Event. I really had a good time here this year, but I wonder if Cameron Muir or Perry Fine or any other AAHPM royalty will break out the instruments. Good thing this is Thursday night, so you can still attend the Pallimed get together Friday night at Backjack's! I can do a wicked beatbox impression of "I Can't Get No Satisfaction" but that is all the music we have to offer. At least until I can get my new cover band started..."Sinclair & The Opiates."
- University of Tampa sunset photo courtesy of flickr.com user joerosh1675
- Band photo Courtesy of C. Sinclair back when I was in my band "Failure 2 Thrive." Seriously.