Thursday is when the conference formally begins. No early riser sessions today, unless you count Hatha Yoga at 6am. The opening plenary should be very interesting as we look towards the future of palliative care from some key leaders in The C-Suite Speaks: National Leaders on the Future of Palliative Care. So many of us work to make sure that palliative care is doing well in the present, that we don't always look towards the future. I'm hoping this session features some bold visions incorporating palliative care through the health care system. The future is on tap again later in the day when JoAnne Reifsnyder speaks on Palliative Nursing Leadership: The Way of the Future , in the first HPNA-sponsored session. 

As the concurrent sessions begin, there is some good diversity in the morning sessions. It is nice to see SIGs coming together to talk on key topics like the Geriatrics, LTC and LGBT SIGs (Three!) endorsed session Improving Palliative Care of the Older Lesbian, Gay, Bisexual and Transgender Population Across the Care Continuum by Tatum, Scott, Fosler. Sexuality and serious illness seem to be a secondary concern even in palliative care circles when we have a whole patient mindset. If the quality improvement movement has not impacted your program yet, you'll want to head to the session from QDACT, PCRN and AAHPM Together We Can Go Farther: Using Palliative Care Collaboratives to Drive Quality Improvement by Bragg, Bischoff, Pantilat, Kamal, and Ast. These groups are working to make quality improvement more practical, which is especially important in the new world of MACRA, MIPS, APM, and VBP. All those letters new to you? You'll need to learn about them soon. 

Thursday afternoon is your first chance to hear from the Developing Country Scholars who will present on their challenges and success around the world. If you have not attended one of these before, the global insight is helpful to align your worldview of palliative care. 

As palliative care moves upstream, we are seeing mandatory involvement BEFORE advanced therapies start, like in left ventricular assist devices (LVADs). "This Was Not What I Had in Mind," and Other Palliative Challenges Encountered in LVAD care by Groninger, Ruiz, Panke, and Kelemen is one of a few heart failure and LVAD sessions to buff up your early intervention skill set. If your palliative care team operates well in a crisis, it is a horse of a different color when there are not many symptoms and no looming rapid decline.

The afternoon also has two sessions that feature Interprofessional Education (IPE) and Collaboration, which is one of the wonderful benefits of having a joint conference between AAHPM and HPNA.  I'll make another plug for book club which is moved from the usual noon/lunch session into the concurrent sessions.

The last concurrent session of the day features talks in some pretty narrow niches, nothing overly broad, for example: National Policy, Extubation in the Home, End-of-Life Issues in Pediatric Bone Marrow Transplant, and how to be a a Better Journal Reviewer. The one I find most interesting is the Palliative Radiotherapy For Hospice and Palliative Medicine Clinicians by Joshua Jones. Radiation therapy can be helpful in many palliative care situations, and we need to build good relationships with our colleagues behind the lead aprons. 

And that night, many of you will be going out to dinner with peers with brains stuffed with new knowledge. If you have any energy left, we would love to see you that evening at the Pallimed / GeriPal party!