Literature Review

How Empath Health integrates end-of-life care into PACEHospice News; by Jim Parker; 6/26/25Under the Programs for All-Inclusive Care of the Elderly (PACE) model, patients generally do not transition to the Medicare Hospice Benefit as they near death. Consequently, Empath Health has taken pains to ensure quality end-of-life care is integrated into its program. Empath considers these services to be a key component of its “Full Life Care” model, that seeks to longitudinally support patients over the course of their serious or terminal illness, according to Dr. Nick Joseph, senior vice president of Empath’s Complete Care Division. The organization provides end-of-life care in the home, with services that mirror its hospice program.

If you feel pain, you are alive. If you feel other people's pain, you are a human being. ~Leo Tolstoy

'Very shocking' | Warner Robins neighbors in shock after elderly couple found dead at their home[GA] 13WMAZ; by Jasamine Lee; 6/26/25A quiet Warner Robins neighborhood is reeling after police say an elderly couple was found dead in what investigators believe was a murder-suicide. According to Warner Robins Police, officers responded to a home on Hillcrest Avenue around 6 p.m. Wednesday for a welfare check. When they arrived, they discovered 88-year-old Robert Moll dead in the backyard from a gunshot wound. Inside the home, his wife, 80-year-old Judy Moll, was also found dead from an apparent gunshot wound... Neighbors said the Molls had been facing serious health issues and that hospice nurses visited the home frequently. Captain Paula Blevins with the Salvation Army said that cases of intimate partner violence often remain hidden. “Intimate partner violence is very heartbreaking, always very heartbreaking,” Blevins said. “It affects more than 12 million people in the United States every year.”Publisher's note: How does your hospice evaluate possible partner violence? How can your hospice prepare - before the fact - to handle such a situation after the fact?

Bioethicists must push back against assaults on diversity, equity, and inclusionThe American Journal of Bioethics; by Nancy S. Jecker, Arthur Caplan, Vardit Ravitsky, Patrick Smith, Kayhan Parsi, Sandra Soo-Jin Lee, Faith Fletcher, Mildred Cho, Keisha Ray; 6/25Nine leading bioethicists, including Hastings Center President Vardit Ravitsky, call for bioethics to affirm its core commitment to justice and act against the dismantling of diversity, equity, and inclusion. In an editorial published in the American Journal of Bioethics, they highlight the current administration’s broadside attack against diversity, equity, and inclusion in higher education, the federal government, and the private sector. “Years of research and data gathering have shown that removing barriers facing marginalized groups improves population health and promotes health justice,” they write.

A lesson in humility: Reviewing medical 'truths'Medscape podcast; by Neil Skolnik; 6/25/25In this month's column, Dr Neil Skolnik delivers a lesson in humility by providing an overview of medical interventions that were obviously correct — until science proved otherwise. These examples serve not as an admonishment of medical practice, but rather as a reminder to physicians and scientists to always examine their assumptions and stay up to date with research, because our understanding of disease states and treatment courses can always change. Although we've come a long way, Dr Skolnik offers this advice: "Good medical advice moves in a zigzag path toward truth, and those who offer it must not pretend to know all the answers."

Regret is the price of playing it safe. Personal perspective: We wait too long to live with purpose.Psychology Today; by Jordan Grumet; 6/26/25Key points:

National Alliance for Care at Home responds to Kennedy and Dr. Oz announcement on health insurance reform pledgeNational Alliance for Care at Home press release; 6/23/25“The Alliance welcomes today’s announcement made by Secretary Kennedy and CMS Administrator Dr. Oz regarding commitments from major health insurers to streamline prior authorization practices, including implementing enhanced digital interoperability standards and reducing administrative barriers,” said Dr. Steve Landers, CEO for the Alliance. “If these promises are fully kept, this could be a meaningful step toward addressing longstanding barriers that have delayed access to critical care at home for patients who need it.”

A pregnant brain-dead woman in Georgia was kept on life support. Experts say it raises ethical, legal questionsABC News; by Mary Kekatos; 6/19/25Adriana Smith, a brain-dead woman in Georgia, was kept on life support until her fetus was viable. Experts say it raises ethical and legal questions. Adriana Smith, a 31-year-old Georgia nurse and mother, was just eight weeks pregnant when she was declared brain dead in February after suffering a medical condition. However, the family claims the hospital told them legally she had to be kept on life support to allow the fetus to grow. The family claims doctors told them they were not legally allowed to consider other options, according to local Atlanta station 11Alive. Last week, Smith's baby was born by emergency Caesarean section, weighing under 2 pounds and needing care in the neonatal intensive care unit (NICU), reported 11Alive.Publisher's note: This situation raises numerous ethical end-of-life questions - highlighting the importance of hospices having or connecting with local ethics experts.

National Alliance for Care at Home champions bipartisan legislation to transform access to quality in-home skilled nursingNational Alliance for Care at Home press release; by Elyssa Katz; 6/20/25The National Alliance for Care at Home (the Alliance) is pleased to support the introduction of the Continuous Skilled Nursing Quality Improvement Act of 2025. This bipartisan legislation, Senate Bill 1920, introduced by Senator Thom Tillis (R-NC) and Senator Maggie Hassan (D-NH) aims to improve the quality and accessibility of skilled nursing care by modernizing Medicaid’s approach to private duty nursing.

Leading PBMs face increasing scrutiny from statesHealthcare Brew; by Nicole Ortiz; 6/18/25Iowa is the latest to impose limits on how PBMs can operate in the state... It all started when Arkansas Governor Sarah Huckabee Sanders signed a law on April 16 saying any company that owns a pharmacy benefit manager (PBM) would be prohibited from also owning or operating pharmacies in the state. That’s seemingly bad news for the Big 3 PBMs—Cigna Group’s Express Scripts, CVS’s Caremark, and UnitedHealth’s Optum Rx, which collectively control nearly 80% of the market—seeing as they all also operate pharmacy chains. Now the state of Iowa wants to get in on the action, with Governor Kim Reynolds signing a law on June 11 to change how PBMs operate in the state.

Sacred moment experiences among internal medicine physiciansJAMA Network Open; by Jessica Ameling, Nathan Houchens, M. Todd Greene, David Ratz, Martha Quinn, Latoya Kuhn, Sanjay Saint; 5/25Some have described sacred moments as sudden intimacies or moments of deep memorable connection with another person. The health care setting is replete with opportunities for the types of human connections that lead to sacred moments, such as times of crises or grief, or conversely, times of great happiness. These moments leave participants with a sense of joy, peace, and empathy for the others involved. In this survey study of 629 physicians, 68% reported experiencing a sacred moment with a patient, and physicians who considered themselves very spiritual or possessing a strong sense of purpose in life or work had increased odds of experiencing a sacred moment. Both experiencing sacred moments often and discussing them with colleagues were associated with less burnout [and] improve[d] physician well-being.

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

From burnout to belonging: Creating space for grief in clinical education American Academy of Pediatrics (AAP) Journals Blog; by Rachita Gupta; 6/16/25 ... While significant progress has been made in addressing burnout and emotional distress in medicine, and in incorporating these topics into medical education, many clinicians remain hesitant and uncertain about how to address grief and distress from patient care in day-to-day clinical practice. This uncertainty exists both in terms of their own experiences and, even more so, in supporting trainees. A lack of emotional processing in these difficult situations can accelerate burnout and further disconnect clinicians from the humanism and vulnerability that are intrinsic to the privilege of practicing medicine. ... The recently published Hospital Pediatrics article by Bloomhardt et al, “Good Grief? Introducing the TEARS Framework for Educator to Support Learners Experiencing Grief,” (10.1542/hpeds.2024-008096) addresses the hesitancy many clinicians experience when assessing learners’ emotional processing during or after distressing patient cases by introducing the TEARS framework. ...Editor's Note: See a related post in today's newsletter, "“Her toes fell off into my hand”: 50 moments that changed healthcare workers forever."