As a result, the ACSDS created the VITALTalk Quick Guides, which can be accessed at www.VitalTalk.org/quick-guides. The Quick Guides serve as a prime example of how unflinching and precise the ACS wants palliative care education and training to be for oncologists, said Ms. Kirch.
The Quick Guides help oncologists choose best-practice options for breaking bad news to a patient, for example: “’Say it simple and stop. (e.g., ‘Your cancer has spread to your liver. It’s getting worse despite our treatments.’),” or for saying goodbye to a patient, “If I don’t happen to see you in person again, I want to make sure that you know I’ve enjoyed working with you. I’ve admired your spirit” or “I’ll miss not seeing you in clinic, and hearing about your life.”4
Palliative training mandated by the two bills would produce more deliverables like the VITALTalk Quick Guides once funding for such programs is made available by the proposed legislation, said Ms. Kirch.
Palliative Care Politics
Dedicating time to palliative care training positions an oncologist to take better care of their patients in the future, said Juan Paramo, MD, FACS, FICS, attending surgeon of oncology at Mount Sinai Medical Center’s Comprehensive Cancer Center, in Miami, FL.
Dr. Paramo also took part in the ACSDS/VITALTalk workshops and said, “although we deal with cancer patients every day, and although we inevitably have to have difficult conversations with many of them, these are not things that they teach us in medical school.”
A vote on the two bills will take place at a time when hospitals in the United States that have 50 or more beds have reported a 157% increase in palliative care activity in the last decade.5
As law, the two bills should also save money. On average, palliative care consultation can be credited for cost reductions of approximately $1,700 per admission for patients who go home from the hospital, and approximately $4,900 per admission for patients who die there.5 This adds up to over $1.3 million in savings for a 300-bed community hospital and more than $2.5 million for the average academic medical center.5
Budget-friendly numbers like these help usher bills such as H.R. 1666 and H.R. 1339 along their way toward enactment as law, but it is the actions brought about by their support that pay the real dividends with improved QOL for a growing and aging patient population, said Ms. Kirch.
“We don’t have acute deaths anymore. We have long-term chronic illness with disease-focused and QOL-focused needs,” she said.
- Patient Centered Quality Care for Life Act, H.R.1666. Introduced to the 113th United States House of Representatives on April 23, 2013. http://beta.congress.gov/bill/113th-congress/house-bill/1666. Accessed April 24, 2014.
- Palliative Care and Hospice Education and Training Act, H.R.1339. Introduced to the 113th United States House of Representatives on March 22, 2013. http://beta.congress.gov/bill/113th-congress/house-bill/1339. Accessed April 24, 2014.
- Palliative Care and Hospice Education and Training Act, S.641. Introduced to the 113th United States Senate on March 21, 2013. http://beta.congress.gov/bill/113th-congress/senate-bill/641?q=%7B%22search%22%3A%5B%22s.641%22%5D%7D. Accessed April 24, 2014.
- VITALTalk. Quick Guides. http://www.vitaltalk.org/quick-guides. Accessed April 24, 2014.
- American Cancer Society. Data sheet: Palliative Care and Quality of Life, the New Paradigm in Health Care Delivery. Washington, DC: October 2013.