Monday, June 29, 2015

A Master of Science Program in Palliative Care?

We’re in trouble.  There just aren’t enough specialists in palliative care to palliate all the suffering out there.  One estimate of provider need is over 5,000 full time employees, which could require up to 18,000 trained providers depending on the proportion of time providers devote to the practice of palliative medicine.

One important strategy to address this problem, as highlighted by the recent IOM report Dying in America is to improve the skills of all providers in the practice of “primary” palliative care. 

Historically, some physicians have turned towards palliative medicine and hospice later in their careers – perhaps out of a desire to broaden the meaning they find in their work. However, board eligibility in Hospice and Palliative Medicine now requires fellowship training.  While this is a wonderful thing for establishing the legitimacy of the field, a potential externality is further threatening the workforce supply.  Not only are there a limited number of Palliative Medicine fellowships, it is very difficult for many mid-career clinicians to obtain training without a major disruption of their lives, such as leaving their practice and/or moving. Currently there are 300-350 palliative medicine fellows in training each year; there are a limited number of opportunities for specialty training for nurse practitioners and no programs we are aware of for physician assistants.

Amos Bailey, MD, a well-known leader in the field of Palliative Medicine and a new colleague of mine at the University of Colorado has a pretty innovative idea.  He has set up a task force to prepare an application to the Board of Regents to offer a new degree program: Master of Science in Palliative Care.  This would be an inter-professional executive Masters that would be provided predominantly online (with three separate one-week on-campus intensives).  This program will be designed for the clinicians (physicians and advance practice providers) who are already working and need or desire more training in Palliative Care.  

As part of this effort, we need to gauge potential interest in such a Masters Program.  Dr. Bailey has prepared a brief (2-3 minute) survey to explore potential demand among physicians and advanced practice providers who might be interested in such a program.  [Click here for a link to the survey]

What do you think of this idea? Personally, I’m pretty sold on the idea.  Currently, the need is so great that I have no worry that such a program would undermine my board certification in Hospice and Palliative Medicine although I can see that being a concern.  We would love to hear thoughts.  Also, any help you can provide in identifying potential participants in the program to respond to our survey would be greatly appreciated. 

by: Dan Matlock, MD, MPH

14 comments:

Penelope B. Perryman, LISW, ACSW said...

Please note for social workers on the team: The California State University Institute for Palliative Care’s Post-MSW Palliative Care Social Work Certificate and the similar preparation and credential offered by the Smith College of Social Work.

Ellen Bischoff said...

I would love to see the day when there is a designated Hospice and Palliative Care Nurse Practitioner program track. I would apply and enroll on the spot.

Alexandra Leigh said...

Brilliant!

Patrick Roney said...

Having Palliative Training is a great idea. Not sure the Master's program is the way to go.

As a practicing physician in the Denver area working as a Medical Director for a small hospice, I obtained my MBA 20 years ago with a considerable time commitment...2 courses a semester for nearly 5 years. That's huge, and one difficult to repeat. We ARE short on good Docs/NP's practicing hospice and pal medicine, and putting a program (barrier?) like a Master's program would be daunting, taking time away from practice (and family). Finding good teachers would be a challenge, as the "better ones" would pr practicing clinicians. Plus the cost of the program would be large (its a university, and needs to charge well for its overhead).

Perhaps a "certificate program" would be better, easier to administer, and more likely to bring forward the people who need/desire the training. Spending a couple of weekend days in a quarter on larger subjects like pain meds, adjuvant meds for pain, prognostication, symptom management, wound care, management of the IDT team meeting, etc would be easier. Not all Hospice docs come from primary care, and don't have a firm grounding in routine care of the Geriatric patient, and sharing experience from those of us that do would be helpful.

Perhaps there would even be $$ out there from a grant to pilot this kind of program, and then take it to the other more than 450 large metropolitan markets in the country.

I'd be happy to help.

Patrick Roney MD MBA

Jerry said...

Could application also be open it to registered nurses with bachelor of science in nursing, maybe also require certification in hospice and palliative nursing - so credentials RN, BSN,CHPN.

Or does the need to prescribe prevent it?

Jerry said...
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Jerry said...
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Alyssa from Minnesota said...

I would enroll on the spot too for a nurse practioner in palliative/hospice track. As a current RN, BSN, CHPN, I am getting my MSN right now, but focusing on management and leadership rather than the NP track as I have no desire to work as a gerentological or family NP. But of I could get specific training to be a palliative NP, I would start immediately.

Jerry said...

Alyssa, I hope you identify a path. We need clinicians more than we do administrators ;^)

Jerry said...

Great idea. Perhaps that certificate option could be one rung on a clinical ladder, with the MSc, fellowship, etc as others.

Jerry said...

Great idea. Perhaps that certificate option could be one rung on a clinical ladder, with the MSc, fellowship, etc as others.

Anonymous said...

As a practicing hospitalist in an academic medical center, I would love to see this option as long as it qualified me to sit for Board certification.

Tania said...

This is a fantastic idea. I would appreciate the opportunity to earn an official certification or masters in palliative care, especially if it lends credibility in the eyes of those hiring providers.

I work in emergency medicine - please don't forget about us as we see a lot of patients with pain crises and/or at the end of life.

Lynn Ryan said...

Ditto! The closest program I have found is to get NP in Gerontology with a Focus on end of life. Self made program!