Literature Review

The importance of humanity in internal medicine I.M. Matters from the American College of Physicians; President's Message by Jason M. Goldman, MD, MACP; June 2025I recently attended the funeral of one of my long-time patients, who had required hospice care after a long battle with heart disease. Many of us have had the experience of telling a patient and their family that their disease has progressed and we have reached the limits of medical science. In training, we are taught to be compassionate but professional, maintaining a certain level of emotional detachment ... As internal medicine specialists, we have the awesome responsibility and privilege to be the doctor for our patients through decades of their life experiences and to offer them not just medical science, but also humanity and comfort. ... One of the greatest acts of charity a person can perform is to attend someone's funeral, as it is the only act of kindness that cannot be reciprocated. This patient had been in my practice for almost two decades, and I had the privilege of taking care of both her and her husband.Editor's note: Re-read this powerful statement, "One of the greatest acts of charity a person can perform is to attend someone's funeral, as it is the only act of kindness that cannot be reciprocated." 

Hospitalists should champion hospice as ‘life with dignity’ Medscape; by Julie Peck; 5/29/25 If anyone can put a positive spin on the end of life, it’s Charles Vialotti, MD, director of Hospice Care at Holy Name Medical Center’s Villa Marie Claire in Bergen County, New Jersey. Violotti, who at the age of 80 lives at the 20-bed Villa Marie Claire to serve its residents full-time, says the hospice industry needs hospitalists’ help with sort of a rebrand, one that will almost certainly have a positive effect on patient and family satisfaction. “Providers used to stress offering people death with dignity. And if you think about that, who is ever going to choose anything that offers death? Death in any form is still death,” Vialotti said. “So, we really like to focus on offering people life with dignity, giving people back choice, giving them the option to structure their final days, weeks, or months the way they would most like to see it happen."

Colorado end-of-life care residency requirement challenged Bloomberg Law; by Ryan Autullo; 5/22/25 A terminally ill Minnesota man is asking a federal court to let doctors in Colorado administer drugs to him so he can die peacefully there, a challenge to the state’s residency requirement in accessing end-of-life care. Prohibiting Colorado doctors from giving non-residents drugs to ease suffering in their final months is unconstitutional, lawyers for Jeff McComas wrote in a complaint filed Thursday in the US District Court for the District of Colorado.

Spouses accused of prescription fraud: Nurse took meds from hospice patients, deputies say The Daily Record; by Staff; 5/22/25 A hospice nurse and her husband are accused of diverting and trafficking controlled prescription medications from several pharmacies during her employment at Liberty Home Health and Hospice. Juana Nicole Hull, 42, is charged with six counts of conspiring to traffic opium or heroin and four counts each of obtaining a controlled substance through fraud; embezzling or diverting a controlled substance; and trafficking opioids. Her husband, 38-year-old Robert Wayne Hull, is charged with six counts each of obtaining a controlled substance through fraud and trafficking opioids. 

Primary mental health competencies for hospice and palliative medicine physicians: A Delphi studyJournal of Pain and Symptom Management; by Lisa Podgurski, Danielle Chammas, Keri O Brenner, Leah B Rosenberg, Neha G Goyal, Maria I Lapid, Sue E Morris, William F Pirl, Bridget Sumser, Benjamin W Thompson, Lindsey Wright, and Daniel Shalev; 5/20/25  Objectives: To establish and prioritize 'primary mental health competencies' for specialist hospice and palliative medicine physicians using expert consensus methods. Results: The expert panel proposed 68 competencies divided into: (A) psychological foundations of serious illness care, (B) diagnosis and management of mental health disorders in serious illness, and (C) systems-based practice. After first-round voting, 23 competencies were recirculated for a second vote. Following second-round voting, 32 competencies were included in the final list: 7 from part A, 20 from part B, and 5 from part C.

Tell us more: The Palliative Care Oral History Project Journal of Palliative Medicine; by Richard E. Leiter, Yilong Peng, and William E. Rosa; 5/19/25 As palliative specialists, we have a unique appreciation for the power of oral tradition—the stories of healing and suffering, challenge and accomplishment, and meaning and purpose that can be honored between us in safe and inclusive spaces. To this end, we take great pride in launching a new Journal of Palliative Medicine (JPM) podcast series, “Tell Us More: The Palliative Care Oral History Project.” Each month, we will sit down with a pivotal leader from Hospice and Palliative Care (HAPC) and do what our field does best—ask questions, listen, and reflect. Through our podcast, we’ll seek to understand the complexities and nuance behind our established practices and processes. Our interviews will be with pioneers from across HAPC’s professions and around the world. 

UAB resident leaders complete Chief Residents Leadership Development Workshop UAB Medicine - The University of Alabama at Birmingham; by Katherine Gaither; 5/19/25 Fourteen UAB chief residents recently completed the Chief Residents Leadership Development Workshop. The program, presented by the UAB Medicine Leadership Development Office, was held on May 9, 2025. The Chief Residents Leadership Development Workshop is focused on helping chief residents from core residency programs build their leadership competencies. The sessions include small-group breakout sessions that provide chief residents with the tools, skills, and learning opportunities to enhance their understanding of interpersonal communication and group dynamics, which are critical to success and satisfaction as clinical leaders.

‘Marathon’ effort to refine end-of-life wound coding runs on McKnights Long-Term Care News; by Kimberly Marselas; 5/28/25 Two key wound care groups are finalizing a proposal for new codes that would help skilled nursing providers avoid newly created diagnoses gaps for end-of-life skin breakdown that could lead to missed reimbursement and potential liability risks. The push comes a year and a half after nursing homes won the right to stop coding wounds that occur as part of dying as pressure injuries, which can hurt their quality ratings. But they also lost any way to code or acknowledge treatment of such skin failure in the Minimum Data Set. ...

Proposed California budget calls for prior authorization for hospice in Medicaid Hospice News; by Jim Parker; 5/22/25 The proposed California budget would require prior authorizations for hospice care within the state’s Medicaid program. Currently, Medicaid managed care plans who provide coverage through the state’s Medicaid system, Medi-Cal, may not perform prior authorizations for hospice. California’s Department of Health Care Services (DHCS) indicated in a 2025-2026 budget revision that this could save $25 million over the next two years and more than $50 million in the long term. If enacted, this would make California the first state in the nation to implement such a rule, according to the California Hospice & Palliative Care Association (CHAPCA). The association contends that the anticipated $25 million in cost savings is “speculative and fails to account for the downstream costs and systemic burdens this proposal would create,” according to a position paper shared with Hospice News. ... CHAPCA recommended to the state government three alternative approaches: ...

White coats, heavy hearts: What to expect as a med student after your first patient death Medscape; by David Brzostowicki; 5/21/25 The first death of a patient represents a profound emotional turning point that reverberates throughout one’s career as a physician. In that critical moment, the shield of clinical detachment gives way to inevitable self-reflection. Daryl Eber, MD, recalls a jarring case of an intubated patient who extubated himself and quickly died after coding. The incident occurred in 2005 while Eber was doing rounds as a medical student at Shands Jacksonville Medical Center (renamed UF Health Jacksonville) in Jacksonville, Florida. Although the patient was not in his direct care, the swiftness with which death took the man has lingered with Eber for two decades. 

Hospice visits and perceived hospice quality among Assisted Living residents Journal of the American Geriatrics Society; by Wenhan Guo, Shubing Cai, Yue Li, Brian E. McGarry, Thomas V. Caprio, Helena Temkin-Greener; 5/19/25 Background: Hospice services are widely used by assisted living residents at the end of life, yet concerns exist about the adequacy and quality of hospice care in this setting. Conclusions: Higher frequency of hospice staff visits was associated with better perceived hospice quality. Policies supporting greater hospice staff engagement, including nonclinical staff, may enhance end-of-life care experiences for assisted living residents.

What is it like to die? University of Minnesota’s VR experience offers some answers. The Minnesota Star Tribune; by Richard Chin; 5/2/25 Our reporter returned from the Embodied Labs experience with some thoughts on what he’d like his last hours to look like. When the University of Minnesota offered to let me experience what it’s like to die, naturally I said yes. Aren’t we all morbidly curious about the undiscovered country, as Hamlet put it, from which no traveler returns? Except this time, happily, I would get to return because it would be a virtual death, an experience in a VR studio that’s part of the university’s Health Sciences Library system.