End-of-life care message shared with health professionals

In his presentation to more than 170 health care professionals at Peninsula Regional Medical Center, Dr. Ira Byock sounded a warning: “We have a public health care crisis surrounding seriously ill and dying Americans.”

Within that warning, he offered a challenge. “In the midst of a true public health care crisis, there is a remarkable opportunity to get this right. The solutions – and there are solutions to the challenge that we face – are right here,” indicating the community gathered to hear his message.

Byock is a leading palliative care physician, author and public advocate for whole-person health care and improved end-of-life care. He visited Salisbury last week for a pair of presentations to the local health care community. Many came having seen Byock interviewed in a segment on “60 Minutes” the previous Sunday.

Thursday evening, he presented his topic, “The Best Care Possible: Clinical and Cultural Leadership for the 21st Century,” to a group of health care professionals — including physicians, nursing home administrators, registered nurses and social workers — during a dinner at PRMC.

On Friday morning, also at PRMC, Dr. Byock’s addressed 35 staff physicians and guests during grand rounds with the topic “What Are Doctors For? The Physician-Patient Relationship through the End of Life.”

He described the public health care crisis as a pair of “tsunamis” that are already being felt: the aging population, as the baby boom reaches old age; and the tidal wave of chronic illness as advances in medical care help more patients survive life-threatening events. “At some point, more disease treatment isn’t better care,” he said.

Byock advocated for a shift in thinking that would not only better serve patients but would also improve health care systems. “The fundamental nature of illness isn’t medical,” he told participants. “It’s personal. The best care for a person has to be consistent with their personal values, preferences and priorities.”

The presentation was a call for advocacy for changes in health care policy to, among other things, remove the barrier that Medicare reimbursement places between curative treatment and hospice care. “There are worse things than having someone you love die; there’s having someone you love die badly. I want to change the conversation in America,” Dr. Byock told the crowd. “We ought to be talking about being able to die with a sense of well being.”

A partnership of area organizations — MAC, Inc., The 50+ Network, Coastal Hospice & Palliative Care and the Richard A. Henson Cancer Institute at PRMC — invited Dr. Byock to Salisbury to speak. His visit was sponsored by the partner organizations and grants from the John B. Parsons Foundation, the Community Foundation of the Eastern Shore and the Medical Staff of PRMC.

The partners brought Byock to Salisbury as part of an ongoing program, now in its fifth year, with a mission to inspire a community-wide conversation about issues related to aging and the end of life. In past years, the partners have delivered presentations on advance directives, self-care for caregivers, and the cumulative effect of grief and loss.

Byock serves as Executive Director and Chief Medical Officer for the Institute for Human Caring of Providence Health and Services, a 35 hospital health system serving communities across five western states. Dr. Byock advances efforts to measure, monitor and improve person-centered care system wide. He is a practicing physician based in Torrance, Calif.

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