Palliative care should be more accessible, bridge gaps in health care environment
Palliative care is a specialized form of medical care that addresses relief of symptoms and provides comfort and support to those living with long-term, serious illnesses, while also taking into consideration the needs of the patient’s caregivers and others impacted by their condition.
Dr. Sean O’Mahony, director of the Palliative Medicine division, came to UTMB in June, having served as professor and Director of Supportive Oncology and Section Chief at Rush University Medical Center in Chicago, and in key roles at Albert Einstein College of Medicine and Memorial Sloan-Kettering Cancer Center.
“I met (UTMB President) Dr. Jochen Reiser and he suggested I take a look at UTMB because of opportunities for growth and development in palliative medicine on all the campuses,” O’Mahony said. “I was attracted to UTMB’s commitment to underserved patients, its prison health population, and its large population of underinsured patients. I’m also interested in the opportunity to develop palliative medicine from the ground up in the mainland hospitals.”
He said the Division of Palliative Medicine was relatively new at UTMB, having previously operated within the Division of Geriatrics.
“Palliative care got traction in the 2000s, and was recognized in 2009 as a specialty,” he said. “It has seen a lot of growth in the last 20 years, but a key barrier has been the lack of development of a skilled work force in this area.”
This care can be important at the end of life, but O’Mahony said it can be important at any phase of chronic illness, adding that he has cared for some patients for several years.
“We assist with complex decision making,” he said. “This is a team-based area of medicine, including physicians’ assistants, nurse practitioners, social workers and chaplains, and we can be involved with patients across multiple settings, including clinics as well as home-based.”
Only a few hundred are trained in palliative care each year, but O’Mahony said that among his priorities is to develop a new fellowship in this area, which would allow UTMB to contribute to the workforce as well as bring new faculty to the university.
“I would like to make it more common to find a palliative care specialist when it is needed,” he said. “We currently have one other physician, one nurse practitioner, a social worker and a chaplain, but I would like to bring in more attending physicians as well as other advance practice providers and social workers.”
He also aims to educate other providers in primary palliative medicine.
“We will be expanding the number of trainees that rotate with the service, so they have the opportunity to observe what we do,” he said. “We will offer a dedicated education of palliative topics, which include management of cancer, pain, and the like. Trainees should have experiential education opportunities to develop their skill sets because they will likely someday be working in a place where they don’t have many palliative care medicine providers available.”
O’Mahony also intends to develop research projects that address the symptom management needs of patients, using data regarding areas of needs of patients to device patient-centric, patient-educational resources to facilitate more effective use of the healthcare system.
“It’s very difficult to navigate the system for patients with chronic illnesses, but for those who also have a cognitive deficit, there’s a problem implementing treatment plans,” he said. “If we identify prevailing areas of cognitive loss, we can tailor a patient-centric education plan manage problems that will help with their cognitive issues, and then it might not be necessary or even contribute to their quality of life to hospitalize them.”
He said a strong focus on educating patients, using a teach-back technique in which patients are asked to explain to their health care providers what they’ve been told to confirm they understand, is among his top goals.
“Palliative care is about helping people live out their life the way they want,” he said. “This care bridges gaps in the current health care environment, ensures patients have a choice in their care, and that their care is aligned with their values and their goals.”