Hospice and palliative medicine physicians have special knowledge and skills to prevent and relieve the suffering experienced by patients with life- limiting illnesses.

What are hospice and palliative care physicians?

Hospice and palliative medicine physicians have special knowledge and skills to prevent and relieve the suffering experienced by patients with life- limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to address the physical, psychological, social and spiritual needs of both patient and family and provide assistance with medical decision-making.

The subspecialty of hospice and palliative medicine represents the medical component of the broad therapeutic model known as palliative care. Subspecialists in this field reduce the burden of life-threatening conditions by supporting the best quality of life throughout the course of an illness and by managing factors that contribute to the suffering of the patient and the patient’s family.

The major clinical skills central to the subspecialty are effective communication skills and the prevention (when possible), assessment and management of physical, psychological and  spiritual suffering faced by patients with life-limiting conditions and their families.

Hospice and palliative medicine is distinguished from other disciplines by:

• A high level of expertise in addressing the multidimensional needs of patients with life-threatening illnesses, including a practical skill set in symptom control interventions

• A high level of expertise in both clinical and nonclinical issues related to advanced illness, the dying process and bereavement

• A commitment to an interdisciplinary team approach

• A strong focus on good communication and the patient and family as the unit of care

What do hospice and palliative care physicians do?

Palliative care focuses on improving a patient’s quality of life by managing pain and other distressing symptoms of a serious illness. Hospice is comprehensive palliative care for patients in their last year of life. Hospice care is provided in patients’ homes, hospice centers, hospitals, long-term care facilities, or wherever a patient resides. Physicians who specialize in hospice and palliative medicine work with other physicians and health care professionals, listen to patients and align their treatments with what’s important to them, and help families navigate the complex health care system.

Discussing medically appropriate goals with patients and their families is a central theme in palliative medicine and is applicable to a wide range of medical specialties that support the subspecialty, including internal medicine, anesthesiology, emergency medicine, family medicine, obstetrics and gynecology, pediatrics, physical medicine and rehabilitation, psychiatry and neurology, radiology and surgery.

Hospice and palliative medicine providers are expected to work closely with an interdisciplinary team that includes nurses, social workers, chaplains, psychologists and other therapists to formulate realistic, effective treatment plans for patients who can present challenging symptoms and psychosocial situations. Clinicians often work with referring oncologists, surgeons, internal medicine specialists, radiation oncologists and interventional radiologists, among others, to provide medically indicated interventions for symptom control when appropriate while balancing quality of life and patient wishes.

Many possible career routes can be chosen after completing formal training in hospice and palliative medicine. Palliative medicine careers cover a spectrum ranging from direct patient care in a variety of settings to administrative roles with less patient care contact. There are opportunities for palliative consultation services in the hospital setting as well as home and inpatient hospice settings. This field also provides expanding opportunities for research. Palliative care outpatient clinics and new models of concurrent care delivery will further expand the diversity of this career.

Keys to being a successful hospice and palliative medicine provider include being empathetic, a good listener and a patient advocate. Maintaining a good work-life balance is critical to being successful in this field. A good hospice and palliative medicine program will support you in these endeavors and help with techniques in self-care that you will need in the rest of your career.

Hospice and palliative medicine can be an incredibly rewarding, fulfilling specialty. It can easily be integrated into many areas of medical or surgical practice and should be considered if you will be taking care of patients who have a chronic or life-limiting illness at any age.

How to become a hospice and palliative care physician?

Hospice and palliative medicine is a relatively new, formally recognized specialty and a rapidly growing field. After completing a one-year fellowship, you’re eligible to apply for hospice and palliative medicine board certification. One of 10 residency programs can be completed before electing to spend an additional year undergoing specialized hospice and palliative medicine training.