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by Christian Sinclair (@ctsinclair)

Another year has passed and we are celebrating the 14th Anniversary of Pallimed. Digitally speaking, 2005 is a pretty long time ago, before Twitter started and when YouTube was only 4 months old. I want to emphasize that what Drew Rosielle started with a single blog post as a 3rd year resident is something all of us are capable of doing. You have knowledge to share with a wider audience. At the time Drew was not an expert in hospice and palliative medicine, but he had passion, and he put his work where people could find it. The goal was not to build a brand or build followers, but to share information he thought would be relevant to his work in palliative care. Knowing these roots, I am on the look-out for clinicians in our field who are publishing independently. We go through dry patches but recently, more palliative clinicians are creating innovative and quality online content and I love it. Here are just a few examples:

Example 1 - Dr. Jared Rubenstein and his Palliative Care Public Service Announcements









Example 2 - The Palliators Podcast - Started by three hospice and palliative medicine fellows Dr. Tara Kattine, Dr. Nancy Hart Wicker, and Dr. Katie Mollow. 4 episodes are in the can and on Apple and Spotify. I hope they keep it going!

Example 3 - Kayla Sheehan and sharing her experience as a medical student with a career goal of hospice and palliative medicine. Follow her journey on Twitter @kksheehan.

Attending: "What specialty are you thinking of?"
Me: "#Palliative"
Attending: "No one has ever said that answer before."

Give me a couple years. I'm rounding up some troops! #hpm

— Kayla Sheehan (@kksheehan) July 23, 2018

Example 4 - Dr. Alex Sable-Smith and his educational YouTube videos focused on Primary Palliative Care. Only three so far but I am hoping for some more.



So maybe you have an idea for a blog, video series, Twitter account, Instagram account or podcast. What is stopping you? Impostor syndrome? Find a mentor to give guidance and encouragement. Not enough time? Build a team and go further together. Technophobia? Google it! There are plenty of free/inexpensive tools and YouTube how-to videos to get it done. I really have learned a lot from Austin Kleon's book "Show Your Work" Here are the key points boiled down.



If I missed some new creative content in our field, please Tweet at me or share in the comments below. When we are celebrating our 28th anniversary I would love to point to examples of other people at their 14th anniversary! Christian Sinclair, MD, FAAHPM is on-call this weekend and still managed to pound out a quick anniversary blog post. He is a palliative care physician at the University of Kansas Health System.

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by Christian Sinclair (@ctsinclair)

We used to publish a lot more article reviews here on Pallimed. Sometimes the analysis would be quite deep and sometimes we would just lump together a while bunch of snippets from key articles. I have been keeping an ever-growing list of articles I would love to write up for the site*, but never seemed to have the time to get to them, and then new ones would come out, that I would want to write about, but they too would just get added to the list. At the end of the year, I would look back on key articles for our field and be pretty bummed out that I never got anything published here about them. A few weeks ago, I ignored my self-deprecation and put out a plea on Twitter for any interested clinicians to join a group and write together and encourage each other, and give feedback to one another.

So I have tons of articles I would love to see discussed widely. But I do not have the time to write ALL of these posts up for Pallimed. I'm looking to convene a writing group of 5-10 #hpm clinicians who would be interested in doing 400-700 word takes on important articles.

1/5

— Christian Sinclair, MD, FAAHPM (@ctsinclair) August 3, 2018

And boom! Just like that nearly 20 people answered the call. We have our first list of articles to be published with a mix of new and old.

You can help us find good articles to cover by commenting here, or tagging @Pallimed in a tweet with your suggestions. If you are interested in joining this group we are already collecting names to join the second wave sometime this Fall. Email christian@pallimed.org or ping @Pallimed on Twtter and we will add you to the list. We have a lot of attending physicians, but only one social worker, one medical student, one fellow, and one nurse practitioner, so we are definately looking for a little diversity of professional experience.

If you have written for Pallimed before, you are not being left out. You will be getting invitations soon to join the Pallimed Writers' Group. If you know me and you are waiting for me to ask you, please do not wait. Write! It is good for your mind and body. Submit something and let's see if we can get it published.

The first review from our Pallimed Writers' Group is published today is from physician Bob Arnold on the 2013 Tarumi article on Docusate vs Placebo for constipation in the Journal of Pain and Symptom Management.

As we get more people published I will add them to alist here to make sure that this group gets credit for the work that they do for all of us.

Also, you may see an increase in emails if you subscribe, so you may want to consider changing to the MWF or weekly email options. You can find them at the bottom of your email from Pallimed.

* along with lists of books and films! Calling any humanities nerds.

List of published Pallimed Writing Group authors:
Robert Arnold
Rebecca Omlor
Drew Rosielle
Ben Skoch
Christian Sinclair

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by Christian Sinclair

Anniversaries are a fun time to celebrate, but the fun ones end in numbers in 0 or 5. For other anniversaries, it is a good time to take stock, reflect on the past and look towards the future.

Today is our 13th anniversary of Pallimed, which Dr. Drew Rosielle started in 2005 when blogs were THE thing to do in social media. We also spent many of those early years helping people understand the power of communication through social media with projects like #hpm chat on Twitter, encouraging tweeting from conferences and the advocacy power of our Pallimed Facebook page. With that focus, we have drifted away from original content being the main thrust of our efforts, but have still strived to create good content with strong posts from great writers like Lizzy Miles and Drew Rosielle among others. We are still dedicated to the website and will continue to post always.

Of course, this effort does not happen without the work of many people. I am indebted to Lizzy Miles (Pallimed editor), Megan Mooney-Sipe (Lead Facebook Contributor), Meredith MacMartin and Renee Berry (#hpm chat) for leading some of the core projects of Pallimed. A big thank you to other volunteers who have helped with various projects in the past year including: Jeanette Ross, Kristi Newport, Ashley Deringer, Gary Hsin, Joe Hannah, Lori Ruder, Niamh van Meines, Emily Escue, Ben Skoch, Jen Bose, Liz Gundersen, David Buxton, SarahScottDietz, Sonia Malhotra and Vivian Lam.

Since Pallimed has always been a volunteer effort, we are of course on the lookout for great new volunteers to join us and if you have been a part of Pallimed in the past, we would always welcome you back. If you have a great idea for a series of posts, podcast, videocast, journal club, book review, film review, journal article review, this is a great place to publish it. If you are not the creative type, there are a ton of admin projects that need to get done behind the scenes. Many hands make light work and I can tell you it is a blast being part of a team that makes a big difference...together. We have an audience of over 50,000 across all of our platforms so if there is something that needs to be said, we can help you say it. If you are not sure what to say, I have plenty of writing assignments where I am looking for writers. As a bonus, this work can be used for academic promotion if that is something you need. I've seen work for Pallimed get cited in promotion applications!

So the state of the blog is steady. We are staying the course, but always on the lookout for other smart, dedicated, passionate people who want to make a difference for palliative care and hospice. Let me know if that is you.

Christian Sinclair, MD, FAAHPM is the Editor-in-Chief of Pallimed. He is always surprised he wrote the most for Pallimed when he had infant twins in his house.

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We have started to get a lot of questions about how best to study for the 2018 Hospice and Palliative Medicine Board Exam. Yes, that one that many of us took a little less than 10 years ago and now it’s coming due. Or the one that you need to take after completing your fellowship this year.

So, to help answer these question, we at Pallimed and GeriPal have created a quick guide to the top 5 resources we use to prep for the boards:

• AAHPM's Intensive Board Review Course: the ultimate live in-person prep that includes a pretty stellar cast of speakers including Mary Lynn McPherson, Kim Curseen, Sandra Sanchez-Reilly, Joe Shega, Drew Rosielle, Michelle Weckman, Scott Schwantes, Janet Bull, Jeff Spiess, and Gregg VandeKieft. The course takes place this August 9-11, 2018 in Minneapolis, MN, and will include both lecture-based content plus lots of exam-type questions to help you pass the test (and brush up on your hospice and palliative care knowledge). Plus you get to hang out with a bunch of cool palliative care colleagues.
• The Pallimed/GeriPal Blogs to Boards Questions: yes, it's slightly dated but hey, so are the exam questions (it takes a couple years for the exam questions to get into real life circulation). Plus, the great thing about these questions is that we can update them on the fly. So if you notice a question or answer that needs updating, send the edits our way and we will make the changes. Questions Only Handout; Questions and Answers Handout
• Essential Practices in Hospice and Palliative Medicine: For those who've been in the field for a while, you may remember the book series called "UNIPAC". This was our go-to resource when studying for the boards 10 years ago, and remains so today, just with a different name. It's a comprehensive 9-volume self-study tool that has been completely updated for its rebranded "Essentials" name. Plus it comes with an online confidence-based learning module to test your level of knowledge and level of confidence in each topic area presented in the book series.
• Fast Facts: a great, free resource for a quick how to for over 350 palliative care issues.
• HPM PASS: Need more exam questions. Get AAHPM's HPM PASS for an additional 150 questions.

We would love to hear what other resources you have used and found helpful. Add them below to the comments section at either the GeriPal or Pallimed websites.

Thanks!

The folks at Pallimed and GeriPal

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by Christian Sinclair (@ctsinclair)

Looking back at 2017, we didn't publish a ton of posts (only 50!*), but we had some that clearly resonated with people and continue to be popular since we keep seeing them show up on social media. Working closely with her, I already knew the great qualities Lizzy Miles brings to Pallimed as a writer and an editor, but looking at the top 10, her experience as a hospice social worker has led to a knack for insightful and practical posts. Her posts also seem to be meaningful to clinicians in multiple settings in addition to patients and families. So here are the top 10 posts of 2017 based on page views:

#10 - Extremis Documentary Falls Short at Oscars, Wins Over Palliative Care by Christian Sinclair

#9 - 14 Ways Hospice Patients Have Said They're Ready to Die by Lizzy Miles

#8 - LGBTQ at the End-of-Life: Needs and Challenges by Vivian Lam

#7 - Lorazepam, Haloperidol and Delirium by Drew Rosielle

#6 - "Going Palliative is Not a Thing by Staci Mandrola

#5 - Facing the Abyss: Planning for Death by Kevin Dieter

#4 - The Emotions of Dying by Lizzy Miles

#3 - Changing Treatment Options in Delirium - No More Antipsychotics? by Drew Rosielle

#2 - Defining Dignity at End of Life: One Question to Ask Hospice Patients by Lizzy Miles

#1 - The Dying Don't Need Your Permission to Let Go by Lizzy Miles

Two important notes of appreciation. One for Lizzy Miles and Vivian Lam who were the key editors in 2017 to help get posts ready for publication. And a big thank you to the 23 writers who contributed to Pallimed in 2017- Lizzy Miles, Drew Rosielle, Kevin Dieter, Vickie Leff, Vivian Lam, Erica Frechman, Paul Moon, Lori Ruder, Arif Kamal, Megan Mooney, Ishwaria Subbiah, Lyle Fettig, Amanda Hinrichs, April Krutka, Jennifer Wilhoit, Paul Carr, Staci Mandrola, Abagail Latimer, Karen Kaplan, Shayna Rich, Meredith MacMartin, Renee Berry and Rick Strang.  Without you, this site would have a much less diverse voice.

If you want to be part of the team in 2018, we are always looking for palliative care and hospice clinicians and advocates who have a passion for the field. We have all sorts of needs and would love to add you to our current team of 17 volunteers. Check out this post to learn more.

Christian Sinclair, MD, FAAHPM is the Editor-In-Chief for Pallimed and a palliative care physician at the University of Kansas Cancer Center. You can find him on Twitter (@ctsinclair).

*for comparison, Pallimed published 297 posts in 2009 (includes the Arts and Cases blogs)!

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by Christian Sinclair

In 2016, I made a list of upcoming events in palliative care and hospice. For some reason, it fell off my list of to-do's in 2017, but I wanted to bring it back because it is good to see all the important things happening in our field. Here are some of the things to put on your calendar right now, so you do not miss them! If you want to help out with maintaining this, it would be great to have a colleague and it doesn't take that long, please email me (below). We could even go crazy with the Google Calendar and make different ones that are relevant to different disciplines/interests, international and add submission deadlines for conferences. Technology makes this simple, I just need a few more hands.

To access these dates via Google Calendar (HTML), click here. (still adding some of the below over the next few days)

Winter (Jan, Feb)

• HPM Board Certification Registration Period Opens (ABIM) - Jan 8, 2018-Jun 14, 2018
• Hospice Medical Director Certification Board Application Open - Dec 12, 2017- Mar 6, 2018

Spring (Mar, April, May)

• Cambia Sojourns Scholars 2018 Letters of Intent due - Feb 1, 2018
• SWHPN Annual General Assembly - March 11-13, 2018, Boston, MA
• The Annual Assembly of Hospice and Palliative Care (AAHPM/HPNA) - March 14-17, 2018 - Boston, MA
• Pallimed/GeriPal 12th Annual Gathering - March 15, 2018 @ 9p ET - Location TBD in Boston, MA
• National HealthCare Decisions Day - April 16 - Nationwide
• Implementation of Quality Measures for Community-Based Care Programs for Serious Illness: A Workshop from the NASEM Roundtable on Quality Care for People with Serious Illness - April 17, 2018 - Washington, DC and Free Webinar
• NHPCO Management and Leadership Conference - April 21-24, 2018 - Washington, DC
• Hospice Action Network Advocacy Intensive - April 25, 2018 - Washington, DC
• Caring for the Human Spirit Conference (HealthCare Chaplaincy Network) - April 23-25, 2018 - New Orleans, LA
• Palliative Care Research Cooperative Group (PCRC) Investigator Meeting - April 25-26, 2018 - Denver, CO
• Palliative Care Quality Network Spring Conference - May 3-4, 2018 - San Francisco, CA
• Hospice Medical Director Certification Board Testing Period - May 17-Jun 5, 2018
• 10th World Research Congress of the European Association of Palliative Care - May 23-26, 2018 - Bern, Switzerland

Summer (June, July, Aug, Sep)

• Cambia Sojourns Scholars 2018 Full Application due - June 1, 2018
• Canadian Hospice Palliative Care Association Learning Institute - Jun 14-16, 2018 - Ottawa, Canada
• HPM Board Certification Registration Period Closes (ABIM) - Jan 8, 2018-Jun 14, 2018
• Hospice and Palliative Medicine Fellows finish and become attendings! - June 30, 2018
• New Hospice and Palliative Medicine Fellows begin! - July 1, 2018
• Hospice and Palliative Care Virtual Conference (NHPCO/AAHPM/HPNA) - July 18-19, 2018
• AAHPM Intensive Board Review Course - Aug 9-11, 2018 - Minneapolis, MN
• AAHPM Pedi-Innovate Course - Aug 9-11, 2018 - Minneapolis, MN
• MD Anderson Updates in Palliative Care and Physician Board Review Course - September 11 – 13, 2018 - Houston, TX
• MD Anderson 22nd Annual Interdisciplinary Conference on Supportive Care and Hospice and Palliative Medicine - September 14-15, 2018 - Houston, TX

Fall (Oct, Nov, Dec)

• 22nd International Congress on Palliative Care - October 2-5, 2018 - Montreal, Canada
• National Hospice Month - Nov 1-Nov 30, 2018 - Nationwide
• NHPCO Interdisciplinary Conference - Nov 3-7, 2018 - New Orleans, LA
• CAPC National Seminar - Nov 7-10, 2018 - Orlando, FL
• HPM Board Certification Exam (ABIM) - Nov 20, 2018
• Palliative and Supportive Care in Oncology Symposium - Nov 16-17, 2018 - San Diego, CA
• NHPCO releases Annual Facts and Figures (usually in the Fall)
• End Well Symposium: Design for the End of Life Experience - Dec 6, 2018 - San Francisco, CA

Recurring

#hpm chat (Twitter) - Last Wednesday night of the month 9p ET - Subscribe to monthly updates on topics at www.hpmchat.org

If you know of any other major events, please add them in the comments below and we may add them to this growing list.

If you would like to help maintain this list and the Google Calendar, it is pretty easy if you have a Gmail address, and can be taught in less than 30 minutes, please email editor - at- pallimed.org.

If you are interested in writing up a report for a major conference listed above, we are always looking for traveling correspondents. Please read this overview of writing conference reports and submit the form on that page.
Christian Sinclair, MD, FAAHPM is the editor-in-chief of Pallimed, and always loves a good conference.

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by Christian Sinclair (@ctsinclair)

Happy New Year! As we look towards the future that is now 2018, many of us make promises which can be difficult to keep, but always with the purpose of working towards the best version of ourselves. (In a way it is kind of like a quality improvement project!) Often these resolutions are personal: exercise 5 times a week, eat more healthy, learn a new language, read more books, spend less time on my phone. Sometimes these resolutions reside in our professional spheres of influence. I thought it would be interesting to see what some hospice and palliative care colleagues are resolving to do in 2018. If you have a resolution of your own, please post in in the comments, or share on Twitter with #hpmResolutions. If you don't want to make it so public you can always talk to the people you work with every day and see what they are committing to this year within hospice and palliative care.

I want end-of-life care conversations to be everyday conversations! So I'm going to try to take those conversations outside the hospital and to the community by speaking at local organizations. - Elizabeth Gundersen, former PCP and hospitalist turned palliative care doctor (@Top_Gundersen)

I am hoping to expand my cultural horizons as I walk the path of chronic illness and death with children and their families. I want to be more mindful of how my actions can fit into their culture as opposed to invade it. - Katie Harmoney, pediatrician, pediatric hem-onc fellow and future pediatric palliative care fellow (@katie_harmoney)

My 2018 resolution is to increase my gratitude to the life and career I have been given through being more focused in the present moment- the future is not guaranteed which my palliative care & hospice patients teach me! - David Bruxton (@DavidBruxtonMD), Palliative Care Physician, Adult and Child Psychiatrist

My 2018 HPM resolution is to wait one beat longer before offering an opinion. “Let me not seek as much to be understood as to understand.”—Prayer of St. Francis. - Joe Rotella (@JRotellaAAHPM), AAHPM Chief Medical Officer

Continue to love and give compassion to ourselves, our patients, their families/caregivers, and colleagues. We are all in this together. - Rab Razzak, (@RabRazzak), Palliative Care doctor at Johns Hopkins

My palliative care resolution for 2018 is to hunker down and really figure out the role of the "patient as researcher" in palliative care. In the spring of 2017, I applied to PCORI for funding on a project called the Brain Cancer Quality of Life Collaborative, which is all about palliative care. I was excited and terrified when I was approved for the funding in the fall of 2017. I am not a clinician, I am not a researcher, and I am not an academic. I am a patient. I know how to bring together the neuro-oncology and palliative care communities, and I know many patients and care partners who are passionate about doing something to improve quality life and palliative care for people living with brain cancer and their families. In 2018, I will fight my imposter syndrome, and I will rock this project. Families dealing with brain cancer (or any serious illness) want to spend time building memories, not navigating the healthcare system. - Liz Salmi (@TheLizArmy), Co-founder of #btsm (Brain Tumor Social Media chat), Communications for My Open Notes

Excited to be working with over 50 external organizations to make new #NCPguidelines a reality and work to implement in all settings. - Amy Melnick (@AmyMelnick1), Executive Director, National Coalition for Hospice and Palliative Care

Learn more about screening for risk of opioid abuse when initiating opioids for pain in the hospital and start doing it! Also, try using dictation for my notes to speed completion and reduce the time spent on documentation. - Meredith MacMartin (@GraniteDoc), palliative care doctor at Dartmouth-Hitchcock health system and Geisel  School of Medicine.

For me engaging with the academic networks to get the algorithms working to identify people better than by surprise question or the like and chatting more to the ED lot. - Ollie Minton (@drol007), Palliative care physician and researcher

My 2018 hospice and palliative medicine/care resolution is to read more journal articles AND then actually post a write-up of them in the spirit of what Pallimed was when Drew first started it. There is a lot of important research being done and it needs to be discussed more! - Christian Sinclair (@ctsinclair)

Some other thoughts on palliative care and hospice resolutions you might want to commit to:
- Contact your local, state and federal legislators for the first time ever (you can talk about the importance of hospice, palliative care, pending legislation about quality of life, etc)
- Read an entire hospice or palliative care textbook
- Submit a conference proposal
- Submit a letter to the editor (local newspaper, NYT, WaPo, medical journals)
- Start a Quality Improvement project around palliative care
- Participate in your first #hpm chat on Twitter (now monthly- subscribe for updates)
- Donate part of your coffee money monthly to a local, state, national or international organization supporting hospice and palliative care
- Mentor, coach or sponsor someone in hospice and palliative care to achieve more
- Write notes of appreciation instead of gifts for your peers and colleagues for holidays and birthdays
- Record a lecture video on a topic you know well and post it online (SlideShare, YouTube, etc)
- Write a post for Pallimed, GeriPal, or Palliverse
- Start your own blog, video channel, or other social media channel dedicated to palliative care knowledge

Feel free to add your own ideas below!

Christian Sinclair (@ctsinclair) is a palliative care doctor at the University of Kansas Health System, and resolution-making and resolution-breaking human being who strives to be better, but doesn't always get to where he wants to be.

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Come one, come all to the 11th annual Pallimed / GeriPal party during the Annual Assembly of AAHPM and HPNA! And right after SWHPN's conference too!

In keeping with tradition, we will host it on the Thursday of the Assembly (Feb 23rd).  We will start at Lustre at around 8 PM and move on from there to Hanny's at 10pm (and then who knows what).  Like always though, these are rough estimates of time, so if you want to know the details, follow the hashtag #HPMparty on Twitter.

Also, feel free to invite and bring anyone, as this is no exclusive crowd.

Ways to follow: 

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Last year the NorthEast Palliatiors from Carolinas Healthcare shared part of their team wellness activity with a Valentine's day theme. This year they shared more Valentine's cards they made and even a team-built poem: An Ode to Palliative Care.

Since February is National Heart Month, and Valentine's is next week, we would love to see the creativity of your hospice and palliative care teams! I'm sure you have at least one Interdisciplinary Team meeting next week, and you probably have some time allotted for education or self-care/team wellness, so let's see what you can do!

Check out our slideshow below or our album on Facebook for some great examples!

Your Valentine's Day creations should integrate a hospice or palliative care theme. We encourage you to keep it positive and affirming, because this may reach a very wide audience and we want to put our best foot forward.

To share your #PallimedValentines with us:
1. Post it to Facebook, Twitter or Instagram
2. Add the hashtag #PallimedValentines
3. Tag us! @Pallimed on Facebook/Twitter, and @pallimedblog on Instagram (Optional, but it helps us find them and might get your post shared more quickly!)
4. Also follow and like us if you are not doing that already.

We'll feature some of the best ones here and across our social media platforms.

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by Christian Sinclair

Eleven years ago today Drew Rosielle posted his first post to pallimed.blogspot.com* about Hospice and Palliative Medicine becoming slated to be officially recognized as a specialty by ABIM and ABFM! We had a great year commemorating our 10th year anniversary. We posted 123 new posts to pallimed.org, a new 4-year high (that we are planning on breaking this year!) The Pallimed Facebook page flew past 10,000 likes, #hpm chat is still going strong, and we are starting to explore other social media platforms like Instagram.

We still have a lot of work to do ahead this year, like:

• further establishing the Pallimed Foundation which will allow us to make Pallimed sustainable and consistent going into the future
• finding a few new assistant editors willing to help writers get their work published
• discovering a new class of Hospice and Palliative Medicine Fellows who are interested in digital communications in health care
• getting back to our roots featuring more journal article reviews
• streamlining content curation and distribution across all the Pallimed branded channels - all 11 of them!
• partnering with other key blogs and digital media through the Pallimed Network to highlight the best writing on hospice and palliative care

We are always on the lookout for enthusiastic and self-starting volunteers, because many hands make light work. If you are interested in being part of Pallimed and have a few hours to invest in the future of hospice and palliative care, then please take a look at our Pallimed Opportunities page.

So now on to the fun! The internet has given us many great new ways to highlight the things we love. One of the more popular memes has been #(Blank)inSixWords. Some variants change the number, but the essence is you have to distill the meaning of something into a small amount of words. The idea originally spang from the Six-Word Memoir, some believe to be made famous by Ernest Hemingway who wrote: Baby Shoes for sale. Never worn. That would surely be Grief and Bereavement in six words.

A few months ago, Dr. Mark Reid (@MedicalAxioms) started the hashtag #SpecialtiesInSixWords on Twitter and palliative care featured prominently. Here are a few of the contributions:

• Palliative Care: We can stop hurting you now. - Mark Reid @Meidcalaxioms
• palliative care: getting it right near the end - Alex Puxty @apuxty
• Palliative Care: Help you live 'til you die - HCSM News @HCSMNews
• Palliative Care: Pain Relief, Symptom Management, Patient Dignity. - Phillip Anthony @nurse_panthony
• Palliative Care - "I'm so sorry. Cup of tea?" - @Emmcm1982
• Palliative Care: I want to see my horse. - @DrJohnAquino
• Palliative Medicine: All medicine's palliative; we're just honest - @AlexBThomson

So to celebrate 11 years of Pallimed, we invite you to share your own Hospice and Palliative Care in Six Words on your social media platform of choice. You can choose Hospice alone, Palliative Care alone or include both, so make sure your six-words begin with what you are describing. Later this year we will feature the different professionals or aspects in six-word stories so

On Facebook: Share them in the comments section of this post
On Twitter: Include #PallimedTurns11 and @pallimed
On Instagram: Include #PallimedTurns11 and @pallimedblog
On Tumblr: Include #PallimedTurns11 as a tag for your post

We will be highlighting some of the best through the year, and will make a few into images to spread around the internet (for which we will ask for permission). Feel free to make an image with free tools like Canva.

We look forward to what you can think of! Thanks for sticking with us for 11 years!

Christian Sinclair, MD is the editor of Pallimed, president of the American Academy of Hospice and Palliative Medicine and a palliative care doc at the University of Kansas.

*That used to be our official address!

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by Christian Sinclair

I am beyond thrilled that we made it to our 10th Anniversary. There were some times in the last few years I thought about shutting it down and simplifying things. But I was thinking only of Pallimed as a blog. Pallimed stopped being just a blog quite a while ago, but many (including me, until recently) may still think of it as only a blog. While the site is still the backbone of the work, the scope of the Pallimed brand has expanded greatly in the past decade. Understanding the behind-the-scenes support (tech, planning, editing) was largely dependent on my own individual volunteering, it was only last year when I realized that plan would not sustain Pallimed into the future. The writers and many contributors to the Pallimed effort have created something grand, and it needs to be able to stand alone as an organization. So this year, in our 10th anniversary, the non-profit Pallimed Foundation was established.

Introducing the Pallimed Foundation

With the establishment of the Pallimed Foundation, we recognize that there are many different aspects to what Pallimed actually does. The Pallimed Foundation will allow us to gather the resources to sustain the work we do into the future and not be dependent on individual volunteerism.

We are still in the planning stages for the Pallimed Foundation, so if you are interested in being a part of this new formal effort, please get in touch. Some basic ideas for the Pallimed Foundation include: becoming a formally recognized 501-c(3) organization so we can accept tax deductible donations, support overdue website and design upgrades, crowd-funding new content for Pallimed, supporting (through grants and coverage) unique real world and digital media projects focused on palliative medicine, reimbursing contributors for their writing and efforts, teaching social media skills to hospice and palliative care clinicians.

Some of you may be concerned about this addition of money into the equation. I assure you, true to our original mission, Pallimed website content will always be free to access and free of advertising. We are strong believers in the open access and Creative Commons movements. Our revenue model will be focused on donations, grants, crowd-funding and pay what it’s worth (PWIW). In the past 10 years, I have personally spent less than $4,000 on Pallimed efforts, but there have been countless opportunities that having established funds could have helped propel something to a new level of engagement. And that is a core tenet of what Pallimed is about: engagement.

Introducing the Pallimed Network

If we have a funding model for long term viability, we also need an organizational approach and structure to the rest of our content creation, and so I am also introducing the Pallimed Network.

Below is the list of current nodes of the Pallimed Network. Some are current, some have lapsed and need to be rebooted, but altogether they can reach a potential audience of over 24,000 non-unique users with each post. In formalizing the Pallimed Network, we can begin to recruit and recognize dedicated volunteers who can lead these various efforts through advocating and scholarly activities.

If you are interested in helping on any of these efforts we are looking for leads and support. We will soon be introducing affiliates of the Pallimed Network as well as stand alone websites for the Pallimed Network and the Pallimed Foundation.

Pallimed Network Properties

Pallimed
- Websites
  - Main
  - Arts and Humanities
  - Cases
- Twitter - @pallimed
- Facebook
- Tumblr
- Pinterest
- YouTube
- Periscope - @pallimed

#hpm chat
- Twitter - @hpmchat

National Hospice and Palliative Care Month*
- Facebook

Other Twitter accounts
- Health Care Chaplain @hcchap
- Hospice and Palliative Med/Care Education @hpmedu

*Pallimed Network does not own any rights to National Hospice and Palliative Care Month, but has maintained the page since 2010.

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By Christian Sinclair

It is quite amazing how far we have come with digital media tools. In 2005, YouTube had just started and was in public beta, Facebook, had just changed from thefacebook.com to facebook.com and was still mulling the decision to let in more than just elite college students, and Twitter, Tumblr, Instagram and Pinterest didn't even exist.

Back in 2005, when Drew Rosielle started Pallimed, blogs were beginning to enter the mainstream as a form of participatory journalism. With more free publishing tools at your disposal, you could spend an hour or two writing an opinion or analysis and instantly share it with everyone with the click of the publish button. Blogs were really the beginning of modern social media since their rise in popularity in the early 2000's and they had a fairly strong base in medicine.  Kevin MD, The Cheerful Oncologist, DB's Medrants, Respectful Insolence, Dr. Wes, Intueri, Clinical Cases and Images, Emergiblog and others helped give a voice to clinicians in the field who wanted to teach and share what they were seeing. Some of those blogs have closed, some have moved to more formal media sites. Not many blogs last 10 months, let alone 10 years. It is exciting to see Pallimed is still here after 10 years.

"Pallimed has not only been a #SOCmed leader in #hpm, but a leader in #HCSM! Congrats on the 10th anniversary!" - Jim Cleary, MD at Univ of Wisconsin via Twitter

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by Christian Sinclair, MD, FAAHPM

So let’s say you can’t get any of your friends or family to get into watching Being Mortal with you on Tuesday night. No worries, we have you covered! With Facebook, Twitter and Pallimed you can find other people who want to talk about the show (and the book). Probably people a lot like you.

First, find it either online at PBS FRONTLINE (starting Tuesday) or check your local PBS listings for the premiere Tuesday night.

Second, if you are interested in being part of the conversation as you watch the show or reflect on it later, you can choose from one of the following ways:

1. Comment on the review post here on Pallimed by Bruce Scott. If you have never commented before here is your chance. The comment systems (DISQUS) is quite simple and you can even reply straight from your email app.
2. If you are already on Twitter, use the hashtag #BeingMortal to share your insights and opinions and find other people talking about it. (PS Great way to find new people to follow and gain new followers too). At 10p ET on Tuesday, you may also find many hospice and palliative care professionals using the hashtag #hpm in addition to Being Mortal. Using a chat website (like this one) will help you follow the conversations better. If you are confused Tuesday night, just tweet at me @ctsinclair.
3. Go to the Pallimed Facebook Event at 10pm ET on Tuesday, where nearly 100 people have already RSVP’d. We should be getting a good conversation going there as well. 

Hope to see you advocating and educating tomorrow night! #BeingMortal Tweets

Photo Credit: Courtesy of Being Mortal by PBS FRONTLINE

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by Christian Sinclair, MD, FAAHPM

Wow, did January move fast or is it just us?

Here is a recap of all of our posts from January 2015. We know there are some you may have already bookmarked, but forgot to read, or maybe you liked it so much you want to share it again.

We hope to see a lot of you in Philadelphia for the Pallimed/GeriPal party on Thursday Feb 26th! Who knows, maybe we'll bring the thickener.

Make sure to follow, engage, like and comment with us on Facebook, Twitter, Google+, Pinterest, Tumblr and LinkedIN.  And we always appreciate it when you recommend us to your peers.

Advocacy

• First #hpm chart of 2015: reflections and a way forward by Meredith MacMartin
• Sharing your genius in hospice and palliative care by Allie Shukraft
• Palliative Care Everywhere! by Cory Ingram

Communication

• Using validation to prevent crazy making in caregivers by Debra Parker Oliver and Jessica Oliver Tappana

Humanities

• Surf Culture: Paddling Out by Holly Yang

Interview/News

• Hospice and palliative care: the year in review 2014 by Christian Sinclair
• Results of 2014 Story of the Year poll by Christian Sinclair

Media Reviews

• Review of the Conversation: A Revolutionary Plan for End-of-Life Care  by Andi Chatburn

Narrative/Opinion

• Benign Prostatic Hypertrophy as a Hospice Diagnosis by Julie Childers
• Stuart Scott and fighting metaphors in medicine by Christian Sinclair
• Why the thickened liquid challenge matters by Christian Sinclair

Research/Education

• National Drug Facts Week by Mary Lynn McPherson
• Palliative care and heart failure in primary care by Katherine Sleeman and Tara Whitburn

Comment Shout-out's - January 2015 (in no particular order):
Holly Yang, Kristina Newport, Steve Smith, Jerry Soucy, Emily Riegel, Alile Shukraft, Jennie Cooper, Karen Kaplan, Clay Anderson, Judy Thomas, Jessica Tappana, Drew Rosielle, Debbie Oliver, Simcha Shapiro, Andrew Kamell, Ruth Hill, Tina K, Julie Susann, Judy from Upstate, Meredith MacMartin, and a few anonymous people.

Highlighted Comment for January 2015
Karen Kaplan's comment on  Using validation to prevent crazy making in caregivers by Debra Parker Oliver, MSW, PhD and Jessica Oliver Tappana, MSW. - January 9, 2015

You so skillfully remind all healthcare professionals to validate feelings and not to forget family systems. What is of interest is how often we need such reminders, which suggests to me that we can have our own issues for resisting validation, which is distinct from not knowing about it or forgetting about it. Validation means we have to acknowledge our helplessness: we can't cure the disease, etc. Validation means we have to face our own anxieties about mortality and pain. Even chaplains, whose training is almost entirely about listening, reflecting and validation in general, often retreat into resistance. Thus we have to keep those reminders coming, and also try to become self-aware of the sources of resistance.


Help wanted
If you are interested in writing for Pallimed please contact us via any of the social media platforms or email editor@pallimed.org. If you want to help we have something you could do! Like write this simple monthly review post (really this would be really great to hand off)! Or help run one of our social media accounts (especially with Pinterest and Tumblr) - we do on the job training!

Christian Sinclair, MD, FAAHPM is a palliative care doctor at the University of Kansas Medical Center and editor of Pallimed. When not advocating for health care professionals to use social media you can find him playing board games.

Image Credit: "January 2015 Pallimed Monthly Review" Christian Sinclair for Pallimed, licensed via CC BY NC-SA 4.0

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Time to gather your peers and join fellow readers of Pallimed and GeriPal for our annual party at the Annual Assembly of AAHPM and HPNA (and anyone still in town after SWHPN's conference on Monday and Tuesday!). Since the last two years were such a success with the progressive party, we will be doing that again this year. We will begin at McGillin’s at 8pm. After that follow the hashtag #HPMparty or our Facebook event page where we will be posting updates on the next location.

All are welcome, this is no exclusive crowd. There will be many writers from both websites at the party and we always like to meet readers and hear your feedback.

McGillin’s is near the corner of 13th and Chesnut just a few blocks South of the Marriott Hotel and Convention Center.

Date: Thursday, February 26th, 2015 - Start time 8pm. End time TBD

Where: Depends

• Only way to find out is to keep up with our twitter and Facebook feeds, or type in #hpmparty in twitter to follow the live feed
• Pallimed Twitter feed / Pallimed Facebook page
• GeriPal Twitter feed / GeriPal Facebook page
• #HPMparty twitter feed
• Facebook Event Page for the party

Starting location: McGillin’s Olde Ale House

• 1310 Drury Street, Philadelphia, PA 19107
• Near the corner of 13th and Chestnut

 Map:

Add it to your Calendar:

#HPMparty Tweets

Photo credit: Liberty Bell by Vishal via Creative Commons https://www.flickr.com/photos/9474286@N05/5996131042

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If you have not noticed by now, we have really started to increase our publishing output, so since some great articles may fall off your radar, we will start doing a monthly review to make sure you didn't miss something really good. And if you are one of the few hundred subscribers with a daily option, do not forget you can always change to MWF or weekly!

Our two most popular posts this month on social media were Emily Riegel's letter to the spouses of palliative care professionals and Bob Arnold's case review of when emotions or facts are at the center of goals of care discussions. Good ones to share with your teams maybe?

Make sure to follow, engage, like and comment with us on Facebook, Twitter, Google+, Pinterest, Tumblr and LinkedIN.  And we always appreciate it when you recommend us to your peers.

Advocacy

• CMS reimbursement for Advance Care Planning by Phil Rodgers
• Articulating the benefits and value of hospcie care by Turner West
• Last minute gift idea - advocate for advance care planning by Holly Yang
• Time for a robust HPM public engagement campaign by Ankur Bharija

Communication

• Finding respect in modern health care by Amy Clarkson
• Cases: Are goals of care conversations about emotion or fact? by Bob Arnold

Interview/News

• Cambia Awards $10M to University of Washington Palliative Care by Christian Sinclair
• Crowdfunding a palliative care service: can it really work? by Christian Sinclair
• Free CE credits for palliative care from MJHS webinar series by Russel Portenoy

Media Reviews

• Getting On: HBO sleeper comedy not shy about delicate topics by Chris Okon
• Review of Consider the Conversation 2: Stories about cure, relief and comfort by Beth Fahlberg

Narrative/Opinion

• How hard is it to get dental care at home? by Christian Sinclair
• Open letter to spouse of palliative care professionals by Emily Riegel
• Mind the Gap: specialty social workers' request of research by Allie Shukraft and Lizzy Miles

Research

• Tramadol-induced hypoglycemia: another reason not to use it by Eric Widera
• Is methadone plus haloperidol ready for prime time? by Drew Rosielle

Comment Shout-out's - December 2014 (in no particular order):
Kyle Edmonds, Clay Anderson, Bruce Scott, Ruth Hill, Kathy Kastner, Michael Chapman, George Handzo, Karen B. Kaplan, Liz Salmi, Drew Rosielle, Hal Grotke, Robert F, Michael D. Fratkin, Judy Connolly, Earl Quijada, Anette K, Jason, Tarris Rosell, Sonia Fullerton, Conrad Williams, Emily Riegel, Allie Shukraft, Marilyn Hofmann-Jones, Amy Getter, Holly Yang, Chri Okon, and a few anonymous people.

Highlighted Comment for December 2014
Drew Rosielle's comment on Cases: Are goals of care conversations about emotion or fact? by Bob Arnold - Dec 3rd, 2014

"Fact clubbing" - I'll start using that. The last few years I've called it 'The Data Dump' in my attempts to help other docs understand how it's a waste of their time and effort.

I think it's tough to teach about this on the fly to docs who don't seem to understand they are data dumping. They are taught how important it is to educate the patient and family on what's going on and feel it's an important duty and may not have a sense that it's effect ranges anywhere from being just a waste of time to frankly damaging the doctor patient relationship. I sometimes tell people (not peers, but residents etc) they are at risk of the main point their patient comes away with is 'Gee my doctor is really smart and knowledgeable' but not what you were actually trying to communicate it.

I think the most effective way of teaching around this point is in communicaiton workshops where you can get docs to role play being a patient (or being a customer at an autoshop even) and then have someone talk to them about what's going on for 120 seconds straight. Many can realize that they start glazing over and not paying attention after just 30 or so seconds. Sometimes can lead to great insights. Sometimes.

Bob; fantastic post I'm going to use this in teaching.

Help wanted
If you are interested in writing for Pallimed please contact us via any of the social media platforms or email editor@pallimed.org. If you want to help we have something you could do! Like write this simple monthly review post! Or help run one of our social media accounts (especially with Pinterest and Tumblr) - we do on the job training!

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What started off as a simple idea to play up the friendly rivalries between cities, was not only really fun but also enlightening.

First off, it was nice to talk about something besides just our work. Just like personal self-care, it is nice to take a break from only focusing on pain, suffering, illness, and death, instead having a little bit of fun.

In addition to the fun, it was nice to see some of the HPC world play along.  We both had a few notable defections to the other side and some trash-talking gamesmanship from people across social media.

Lastly, it was an important lesson in tying our work to things that are important to the public-at-large. Maybe in the future we will see some of our larger palliative care and hospice organizations jump on the friendly sports wager bandwagon bringing more public attention to the good work that all of us do each day.

Imagine if the Kansas City Hospice and Palliative Care and the Zen Hospice Project of San Francisco volunteers offered some of their unique projects in a charitable side bet.  Or maybe, the palliative care departments of UCSF and the University of Kansas (*the Royals do play in Kansas City, Missouri FYI) put a grand rounds guest speaker on the line, in addition to local wares and treats. You don't have to have a blog to do this. So when the NFL, NHL, MLS, NBA, MLB championships are on the line, let's get creative and spread our good work to new audiences that doesn't always have to focus on our expertise. If you do make one of these fun wagers, please let us know.  We will be happy to feature it!

Don't forget to look for our three guest posts coming from GeriPal to Pallimed in November and December and four of our writers sharing their work with GeriPal.

Now that the series is complete, here is what the Alex Smith, Eric Widera and the rest of the SF-based Geripal crew will be receiving from Kansas City in the next few weeks:

• Christopher Elbow Chocolates - 16 piece assortment 
• Fiorella's Jack Stack BBQ - BBQ Super Sampler
• Lost Trail Root Beer - 12 pack
• The Roasterie Coffee - Sporting Champions Blend

Here you go Geripal, I believe this is yours!

In closing, here is a quote sent to me by Earl Quijada towards the end of the game last night.  He rightfully pointed out there is plenty in this quote to align with our work in hospice and palliative care.

“[Baseball] breaks your heart. It is designed to break your heart. The game begins in the spring, when everything else begins again, and it blossoms in the summer, filling the afternoons and evenings, and then as soon as the chill rains come, it stops and leaves you to face the fall all alone. You count on it, rely on it to buffer the passage of time, to keep the memory of sunshine and high skies alive, and then just when the days are all twilight, when you need it most, it stops.” - Bart Giamatti

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When my adopted hometown of Kansas City is going this crazy over the Royals being in the World Series for the first time in 29 years, you start to get caught up in the fun.  So to add another layer on top of the fun, I decided to make a friendly wager with San Francisco's very own Eric Widera and Alex Smith of Geripal.  Several bloggers for Pallimed are based out of the Kansas City metro or have Kansas City roots (Amber Wollesen, Amy Clarkson, Holly Yang, Emily Riegel, Gary Buckholz, Jenni Linebarger, John Hennessy) although we (like Geripal) have representation from all over.

So we have the San Francisco Giants/Geripal versus the Kansas City Royals/Pallimed for the World Series of Baseball/Blogs.

The basic rules are thus:

- For each loss in the series, the losing blog must write a post for the opposing blog. So, for example, after the Royals crush the Giants in Game 1 Tuesday night, a Geripal blogger will write a post for Pallimed. Timing doesn't have to be the same night, so when the Royals complete their sweep 4 games to zero, the Geripal authors can take their time writing their wonderful palliative articles.

-In addition, at the end of the series, the losing blog must send a dinner themed from their city. So for example, in the unlikely event that the Giants break America's heart since the nation is obviously rooting for the Royals, we at Pallimed will send burnt ends and BBQ from Joe's Kansas City, Boulevard Beer Tank 7 Farmhouse Ale, and Christopher Elbow chocolates. When the Royals win, GeriPal will send Pallimed a dinner of something like sourdough bread, Mt. Tam Cheese, and It's Its.

We may negotiate the finer details, but those are the basics. If you the readers come up with any other grand ideas for this wager, please let us know!

And Alex and Eric...Hunter Pence thinks a blog is something that comes out of his nose.