New Report Calls for More Exposure to Palliative Care
A new task force report from the Department of Family and Community Medicine (DFCM) lays out a road map to build palliative care capacity amongst DFCM’s teaching faculty, medical students and residents. As well, an important aim is to raise awareness of the importance of primary palliative care throughout the Faculty of Medicine.
In recent years, the role of palliative care in addressing the needs of Ontario’s aging population has been in the spotlight. While many people continue to associate palliative care with patients dying of cancer, there is now clear evidence of the benefit not only for all life limiting conditions but from the time any of these are diagnosed. Benefits include better health outcomes for the patient, including fewer symptoms, fewer hospital visits and for many populations, palliative care actually lengthens life.
In Ontario, much of palliative care is delivered by family physicians, whether they call it this or not. Some family doctors still have misconceptions about what palliative care is and entails, says Jeff Myers, Head of DFCM’s Palliative Care Division.
“Primary palliative care is the kind of supportive care that’s needed alongside disease focused care and throughout a patient’s life-limiting illness,” says Myers. “Family doctors do this every day, but may not label it as palliative care.”
In 2015, DFCM struck a palliative care task force to examine the state of palliative care training throughout DFCM’s and the Faculty of Medicine’s education programs. A report by the task force emphasizes the need for more exposure to palliative care at all levels of education and training. For instance, the report cites research that outlines exposure to palliative care during undergraduate medical education likely impacts whether or not family physicians maintain palliative care as part of their practice.
The report also points out the requirement that every DFCM resident graduates with palliative care competencies. The report recommends that all residents follow patients with life limiting illness throughout their family medicine experience including end of life, similar to maternity care. To do this, the authors outline family medicine preceptors who maintain clinical palliative care as part of their practice will need to serve as role models for both undergraduate and postgraduate learners. In addition to providing direct care, specialized palliative care clinicians will need to serve as mentors for their family practice colleagues.
But meeting primary palliative care needs of a patient population cannot be done by family doctors alone. It will also require a cadre of non-specialized palliative care clinicians (e.g. family health teams, oncology teams, cardiology teams, respirology teams etc.) who care for people with life-limiting illness to attain and maintain primary palliative care competence. To facilitate this, the report also calls for a coordinated communications effort to expand awareness of primary palliative care across the Faculty of Medicine and working with partners to collaborate on palliative care improvement efforts.
“This report brings an opportunity to highlight that palliative care is everyone’s business. The earlier and more often we expose learners to palliative care the less likely misconceptions develop and the more likely the palliative care related needs of patients and families can be met” says Myers. “More education around palliative care will help everyone – family doctors, specialists and others - to understand that palliative care is not just end of life care, but required throughout a patient’s life-limiting illness.”