Some Highlights from the Web

Nothing too hard hitting in this one, those last two posts wore me out. And I like many other fellowship program directors around the country are busy getting our fellowship applications ready for the first round of accreditations due in the next several weeks.

The Happy Hospitalist found a picture on Flickr took a picture from his service reflecting what he sees regularly. His blog post was then picked up by the WSJ Health Blog. The title of his post was "87 years old" and the caption read: A photo worth a thousand words. Now…. multiply by five. One hospital. One service. One day. Mine. This is American health care. It inspired very different takes on his own blog and on the WSJ Health Blog. Read the comments for a pulse of American view points on aggressive ICU care for the elderly.

The WSJ Health Blog also rediscovered a 2006 National Geographic image about the likely causes of death. The image is called the 'death spiral' although it is really more like a Venn Diagram and each circle within representing the likelihood of occurrence based on the size. The line on the outside...that represents the risk of dying if you are living. Mortality risk 1 in 1. Kind of like the satirical paper The Onion reminded us in 1997.

House calls may be making a comeback as featured in the Boston Globe op-ed, but as many hospice physicians know, there are already a lot of us making these home visits. It is always a delight to see people's expressions when they hear you make house calls. Many really don't believe you until you show up at their home.

On the heels of the Medicare Hospice cuts post, comes this study alerted to us by an anonymous poster that demonstrates wide regional variations in hospice density. Unfortunately it was only a paper presentation and not yet published so all we have to go on is the press release text and a small image map, without a clear legend. I am still having trouble with this paragraph in the press release:

On average, the study found, counties have 2.1 hospices located within their borders, but the number ranges from none to 125. When the researchers looked at 60-mile-radius service areas — the range recommended by the National Hospice and Palliative Care Organization — the average number of hospices serving a county was just over 52. But it ranged widely – from none to 280.

Maybe Dr. Silveira could let us in on what the colors mean, if anyone knows her tell her to drop by and fill us in. (She is the winner of the 2006 AAHPM Award for Young Investigators BTW) Dr. Silveira emailed me the key below.

The colors 'categories' on the map mean the following:
> red - highest hospice availability (taking into account 60mi service area around each office)
> orange -medium
> cream - average
> light blue - low availability
> dark blue - lowest availability
(added April 4/22)

The AAHPM opened the first call for the Annual Assembly 2009 in Austin, TX. I will have an upcoming post on how to submit a proposal to a conference, and will welcome any tips from long time presenters to help anyone relatively new to the process. Also, I will make a plea for someone to submit a Philosophy talk about death and dying so I can go to it next year. We need some contemplative/insightful talks at AAHPM next year. If you do propose it and it gets accepted, I promise to plug your talk here before the next conference and get hundreds of people to show up. Well...at least I promise I will show up.

The Hospice Foundation of America has a good hospice news blog that covers focuses on slightly different topics than we do here. I wanted to alert our readers to a two great links HFA Blog highlighted (1, 2). The Concord Monitor received a Pulitzer Prize for Photography for a series on a dying woman's wish to leave a final gift to her children. There is a wonderful narrated slideshow of the prize winning photographs accompanying the article. The second item is a Guardian (UK) photo exhibit of people photographed alive and on the day they died. Wonderful, touching images that are currently on display at the Wellcome Collection.

And you may have heard about bloggers writing until they die. Well, Drew, Tom and I are doing OK, so don't worry about us!

NOTE: Correction made 4/15/08 in second paragraph. Added hospice color key 4/22/08