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Why Palliative Care?

Updated: Mar 22, 2021

Trying to figure out what kind of doctor you should become? Wondering what specialty you should choose? Then SheMD's Why Specialty Series is perfect for you! We're bringing you female physicians sharing WHY they chose their specialty. Today's post is on why Dr. Roth chose hospice and palliative medicine and why this field might be a great fit for you.

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I was fortunate to be introduced to hospice and palliative medicine (also known as palliative care in Canada) during an internal medicine subspecialty rotation as a medical student. During my three week rotation, I immediately fell in love with the specialty. The ability to provide multidisciplinary care – working with nurses, pharmacists, occupational therapists, social workers, physiotherapists, and other specialists – was unique, and providing holistic, patient-based care was revolutionary to me. I found it immensely rewarding to provide symptom relief to patients, while tailoring care based on their goals. As a medical student, I had been interested in many facets of medicine, but this was the first time I could truly see the difference our care was providing.

Knowing that I wanted to pursue a career in palliative care, I completed a residency in family medicine and then a year of enhanced skills in palliative care. In Canada, you can become certified in palliative care either through a one year enhanced skills program after completing a family medicine residency or by completing a two year subspecialty program through the Royal College after completing a residency in internal medicine, anesthesiology, or neurology (prior to 2017, these two programs were conjoint through the College of Family Medicine and the Royal College as a one year program).

In the United States, certification in hospice and palliative medicine is through a one year hospice and palliative medicine fellowship done through the American Board of Medical Specialties or through the American Osteopathic Association Bureau of Osteopathic Specialties (1).

I currently practice full time as a palliative care physician. Our program is unique in that we provide comprehensive palliative care, with longitudinal clinics to follow patients in the community, as well as providing home visits, rural care, hospice care, and inpatient consultations – in one day I can go from the hospital to the hospice, and then to someone’s home. I work within a multidisciplinary team, consisting of palliative care nurses, physiotherapists, occupational therapists, chaplains, pharmacists, social workers, child life specialists, and spiritual care.

Reasons why palliative care might be a good fit for you:

1. Working within a multidisciplinary team

Palliative care teams can consist of a variety of multidisciplinary team members, including (but not limited to) physicians, nurse practitioners, nurses, chaplains, physiotherapists, occupational therapists, child life specialists, and pharmacists. This provides a rich and educational environment to work in and allows the team to provide truly comprehensive care to patients and families.

2. Caring for a wide variety of conditions

Palliative care provides care for patients with both cancer and non-cancer diagnoses, ideally from the time a patient receives a life limiting diagnosis until the time of their death, with supports increasing as needed along their journey. It truly is a profession where life-long learning is not only necessary but encouraged.

3. Providing holistic, patient-focused care

Care is focussed on a biopsychosocial spiritual model of care – which is why a multidisciplinary approach is key. As a physician, I am afforded a generous amount of time to care for my patients – to get to know them and their goals, and to develop a care plan focussed on addressing their concerns. This is immensely rewarding.

4. Compassionate, dignified care at end of life

Palliative care grew out of hospice care and a key tenant is providing compassionate and dignified care at end of life. This is immensely important, fulfilling work – and care that sadly the majority of Canadians do not have access to (only 1 out of 6 Canadians receives palliative home care in their last year of life; 2). In the US, hospice care is funded under Medicare.

5. Ongoing education

Since palliative care is a relatively new field, there are many opportunities to contribute to ongoing education and awareness, both in medical and public spheres. There is no direct entry to palliative care from medical school, so physicians enter from many different backgrounds after already having completed a residency. I learn from my colleagues, as well as patients and families, on a daily basis!

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