Two parts accomplishment, three parts potential. That, to me, describes the current state of palliative medicine.
How can that be, you ask? After all, palliative medicine is now a recognized subspecialty. And the clinical domains of good palliative care are being adopted widely.
So why is the promise of palliative medicine yet to be realized, and what will it take to translate potential into accomplishment? While palliative medicine practices are delivering exceptional care to those with life-limiting illnesses, many demonstrate unfilled potential. Why? Because they’re undercapitalized; not financially, but intellectually. The bulk of each practice’s intellectual capital has been invested in the clinical knowledge residing in the physician’s head. And that’s the way it should be. But what about other intellectual capital—efficient workflow processes, coding expertise, knowledge of palliative medicine reimbursement nuances, practice analysis intelligence, software, and marketing know-how—so essential to the achievement of a high-performing practice? Most palliative medicine programs labor without this intellectual capital, and find themselves a year or two later scrambling to justify continued viability either of the practice itself or the palliative program associated with it.
Sponsors of palliative care programs, usually hospitals and hospices and most surely all well-intentioned, discover that sustaining (and growing) a program requires a different set of skills and expertise than developing the program. They also underestimate the importance of organizational structure in the success of the program. My aim is of this forum is that we'll examine the key elements of APCOs, the barriers to success and how they might best be removed, and why the shortage of palliative care specialists threatens to stifle the progress of end-of-life care.
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