Literature Review

The Green Wave: Medical marijuana patient enrollment grew 610% since 2016 InvestingDaily, by John Persinos; 4/18/24 The Centers for Disease Control and Prevention (CDC), the Department of Veterans Affairs (VA), and the University of Michigan recently issued a report about a staggering surge in enrollment in state-sanctioned medical marijuana programs across the nation. The report was published last week by the journal Annals of Internal Medicine. Between 2016 and 2020, the number of patients enrolled in medical marijuana programs in the U.S. grew “dramatically,” the report says, rising from about 678,000 in 2016 to more than 3 million in 2020. “This analysis indicates a 610% increase in patient number in the United States from 2016 to 2022,” the report states.

Clinician burnout and effectiveness of guideline-recommended psychotherapies JAMA Network - Psychiatry; by Nina A. Sayer, PhD; Adam Kaplan, PhD; David B. Nelson, PhD; et al; 4/17/24 Importance: Clinician burnout has been associated with clinician outcomes, but the association with patient outcomes remains unclear. Conclusions: This prospective cohort study suggests that clinician burnout was negatively associated with patient outcomes from evidence-based psychotherapies. Findings support research to test the hypothesis that interventions to reduce burnout may improve outcomes from guideline-recommended psychotherapies for PTSD. Future work should determine when and how burnout is associated with intervention delivery and patient outcomes.Editor's Note: Most research on hospice and palliative clinician burnout focuses on physicians and nurses. Examine this in light of your psychosocial/spiritual professionals, i.e. social workers, chaplains/spiritual care, and bereavement counselors. 

5 steps to cutting the red tape that adds to doctor burnout American Medical Association (AMA), by Sara Berge, MS; 4/16/24 ... Reducing burnout is essential to high-quality patient care and a sustainable health system. The AMA measures and responds to physician burnout, helping drive solutions and interventions. ... Dr. [Kevin] Hopkins identified the five steps below to get rid of regulatory make-work that interferes with patient care and contributes to physician burnout.

Health care system eats away at the doctor-patient relationship The Boston Globe; updated 4/17/24... The system economically rewards throughput (the number of patients seen per unit time) and procedures rather than the time needed to develop an open and communicative doctor-patient relationship. While a good physician might understand the tests and evaluations that are indicated by a presenting medical problem, the excellent clinician knows which tests and evaluations should not be done. This is primarily ascertained by delving into details of the patient’s physical, psychological, social, family, and economic history. This process, as James highlights, can lead to collaborative and more effective care. ...Editor's Note: This article highlights "Dr. Thea James’s remarkable work at Boston Medical Center in addressing structural inequity in medical care as a means of enhancing outcomes brings up an underlying structural problem across the entire medical care system (“Her health equity message being heard,” April 13, 2024.)

Shared decision-making between nephrologists, patients key to conservative kidney management Healio, by Mark E. Neumann; 4/15/24 ... Conservative kidney management: Patients who decline dialysis treatment do so for many reasons, Fahad Saeed, MB, BS, and colleagues wrote in a paper published in the American Journal of Nephrology. Patients told researchers that quality of life; fewer symptoms caused by dialysis; more personal time; avoiding the burden of dialysis, including for family and friends; witnessing a family member or friend on dialysis and wanting to have a peaceful death were reasons to select conservative kidney management.

Comment: Rule must change to allow dialysis as end-of-life care HeraldNet, by Matthew Rivara and Mackenzie Daniek; 4/13/24More than 1 in 7 American adults live with chronic kidney disease, making it one of the most common chronic disease conditions in the United States. ... Medicare will generally not reimburse health care providers for dialysis treatments if a patient has elected to enter hospice care, as dialysis treatments are considered by Medicare to be “curative” rather than “palliative” care. Because of this, most patients getting dialysis for ESRD must forego all dialysis treatment after entering a hospice program.

Physician coaching by professionally trained peers for burnout and well-being: A randomized clinical trial JAMA Network; by Stephanie B. Kiser, MD, MPH; J. David Sterns, MD, MPH; Po Ying Lai, MS; et al; 4/12/24Findings: In this randomized clinical trial of 138 physicians, participants who received 3 months of coaching by professionally trained physician peers had a statistically significant reduction in interpersonal disengagement and burnout, with improvement in professional fulfillment and work engagement.

Medical marijuana program enrollments up 500% from 2016 to 2022 Green Market Report, by John Schroyer; 4/11/24The increase was partially due to a rise in mainstream "cultural acceptance of cannabis" and corresponding interest in medical uses. A new federally funded report that tallied medical marijuana patient statistics from across the country found a dramatic increase of registered cannabis patients over a seven-year period, from roughly 678,000 in 2016 to more than 4.1 million at the end of 2022.

3 ways advance care planning empowers people TCPalm, Visiting Nurse Association, by Lauren Gruber; 4/10/24 ... National Healthcare Decisions Day on April 16th, which seeks to inspire, educate and empower the public and providers on the importance of health planning, is a prime opportunity to consider enrolling in an advance care plan. Identifying the right caregiving plans may seem daunting at first, but it’s important that patients solidify an advance care plan for the security and peace of mind of themselves and their loved ones. ... Here are three ways why choosing an advance care plan through the VNA can empower patients to ensure the best care possible during their health care journey:

Readers share stories of their loved ones’ deathbed visions DNYUZ; 4/10/24 When I started reporting “What Deathbed Visions Teach Us About Living,” about the visions, often of loved ones, that some people have in the final stretches of their lives, I had no idea just how universal the experience was. But within minutes of the story’s publication, readers took to the comments section to post their own memories of having witnessed the phenomenon. The stories were rich, deeply personal, and seemed to confirm something that the researcher featured in my story, Dr. Chris Kerr, knew in his years of studying such visions: they bring peace to the dying and solace to the living. Family members wrote in with stories of watching loved ones have visions, as did health care workers, who had years of experience witnessing them. [Click on the article's title to read more stories.]

The transformative power of art in palliative care patients Hardwood Paroxysm, by Shannon Bailey; 4/10/24 Art can often express what is difficult in words. ... Carles joined the program weeks before his death and after undergoing other treatments such as surgery, chemotherapy, radiotherapy or immunotherapy. ... [His partner and mother of his twin daughters described,]  “The art therapy sessions were the most anticipated moment of the day during his stay in palliative care. For him, this was a way to express his feelings. A space for self-care, intimacy, meditation as well as connection with his closest beings.” [Read more for ...]

The Sunday Read: 'What deathbed visions teach us about living' New York Times Podcasts, 4/7/24 Chris Kerr was 12 when he first observed a deathbed vision. His memory of that summer in 1974 is blurred, but not the sense of mystery he felt at the bedside of his dying father. ... Kerr now calls what he witnessed an end-of-life vision. His father wasn’t delusional, he believes. ... Kerr followed his father into medicine, and in the last 10 years he has hired a permanent research team that expanded studies on deathbed visions to include interviews with patients receiving hospice care at home and with their families, deepening researchers’ understanding of the variety and profundity of these visions.

Care partners have an increased loneliness risk HCP Live, by Chelsie Derman; 4/8/24 The study highlights how the experience of loneliness for care partners of people with dementia changes relationship roles throughout the dementia trajectory. A new study sought to widen the knowledge gap on why people with dementia and their care partners have an increased loneliness risk and identified primary themes: losing external social networks, losses with the dyadic relationship, and the burden of a care partner supporting their loved ones.Editor's Note: