[I would like to introduce a new contributor to Pallimed, Holly Yang, MD  from San Diego Hospice and The Institute for Palliative Medicine. I have been courting Holly for a while to get her to blog for us, so I am glad to see her debut today! You can also find this web- and ocean-surfing doctor on Twitter by the handle @hollyby.  As with all of our contributrs all posts are her own and not the opinion of her employers.  Please welcome her with a few comments - Sinclair, ed. ]

As one of the comments on the Economist website said, “What the heck do they want to promote now – Death Tourism?” As much as I love traveling, I’m not packing my bags just yet. But, I will give you the low-down on the 39-page Quality of Death (QOD) report by the Economist Intelligence Unit and commissioned by the Lien Foundation, which ranks end-of-life care across 40 countries.  Go get your travel kit ready... here we go!

A couple of recent NY Times articles.

The most salient one is a discussion of the movement in Washington State to officially DO SOMETHING about prescription opioid abuse, coming on the heels of course of the FDA rejecting the current REMS plan as, essentially, not going far enough.  The article basically discusses the discussion in Washington about what to do; no formal new plans have been offically proposed as far as I can tell from the article.  This is what they mention that is being discussed:

The regulations would not affect how narcotics are used to treat patients with cancer or those at the end of life because experts agree that such patients should receive as much pain medication as necessary.  
The panel is expected to require that, among other things, doctors refer patients to a pain specialist for review when their daily medication increases to a specified dosage level and they do not show improvement. The specialist can then determine whether to continue the drug, reduce it or use other treatments like physical therapy.

“This is not just about addicts but little old ladies with arthritis starting to die because of this kind of medical practice,” said Dr. Alex Cahana, a pain specialist involved in devising the regulations in Washington State.

And now for a little talk about six-pack abs...(not mine)

I am sure most of you have heard of if not seen the Old Spice Man (aka Isaiah Mustafa) and the sarcastic send up of all things macho.  The first one aired during the Super Bowl and was considered a marketing success with a strong post-Super Bowl viral spread. [For email subscribers, click here to go to the post on the web to see all the videos in this post]

Hopefully most of you have heard of Atul Gawande, one of the more prolific and best physician writers of the past decade.  You may have even read one of his books: Better, Complications, or The Checklist Manifesto.  I was curious if he was going to get around to focusing on palliative care. The New Yorker published his latest article, called 'Letting Go' early online for the August 2nd edition of the magazine.

(See the previous post for info on the Life Before Death site and outreach campaign)
The Lien Foundation and Singapore Hospice Council have released the first international Quality of Death Index.    Even the name of the report is pretty interesting.  I wonder how long they took deliberating about the name.  obviously a play on Quality of Life, but POW! 'death' right there in the name, not 'end of life' or some euphemism.  But that underscores one of the main goals of decreasing the taboo about dying and increasing the conversation.  For the index they ranked 40 countries along the following areas:

• basic end-of-life healthcare environment
• availability of end-of-life care
• cost of end-of-life care
• quality of that care

Effective use of social media in health care can be elusive.  It is one thing to say 'Be our friend on Facebook' or 'Follow us on Twitter', but quite another to foster a community.  As Steve Smith, CEO of AAHPM Tweeted tonight:

  ssmithaahpm Martha Twaddle spoke to the AAHPM staff this week about "finding her tribe" in palliative care; this feels like the Twitter equivalent! #hpm -8:50 PM Jul 14th, 2010

The Twitter equivalent Steve is referring to is the first Twitterchat for Hospice and Palliative Medicine which took place Wednesday night.  I never announced it on the blog, but instead Tuesday night sent out a tweet announcing the event less than 24 hours away:

ctsinclair Official Announcement of the first ever Hospice and Palliative Medicine TweetChat Wed at 8p CST use hashtag #hpm
11:11 PM Jul 13th via web

We are glad to have you here at Pallimed if you have come to us from the recent Mashable post on 5 Ways Social Media Promote Good Health.  (For our regular Pallimed readers, Mashable is the top site for all things social media and the #3 ranked blog by Technorati.)

American Journal of Respiratory and Critical Care Medicine (AJoRaCCM!) has published a randomized trial of two methods of prognostic disclosure about critically ill patients.  The exclamation points represent artifacts of my slack-jawed shock when I read the article's title:  a controlled trial evaluating how we should talk with patients is a very rare thing.  Although while after reading the trial, my reaction is more of a (!) - more questions than answers dammit! - why does it always have to be this way! - one wasn't of course expecting big answers, and the trial highlights some important questions. 

This is a reminder that the deadline for submissions for the Educational Exchange at AAHPM 2011 is next week - July 16.  See my prior post.  It's a really good thing.  Link to more information is here.

And a few editorials/commentaries recently that I loved, or didn't love, but I thought were worth mentioning, acknowledging that I probably won't be blogging about them in any depth.

[ATTENTION: If you are apathetic or antagonistic towards social media of if I (or someone else) have ever turned you off with all this social media talk, I beg you to please read this one blog post if you care an ounce about hospice and palliative medicine.]