Literature Review

Medicine—Both a Science (Care) and an Art (CARE) JAMA Network - Viewpoint; by Theodore J. Strange, MD and Mario R. Castellanos, MD; 4/3/24In the current era, health care is increasingly characterized by the integration of big data, predictive analytics, medical devices, and artificial intelligence. These technological advancements have undoubtedly transformed the landscape of medical care, offering unprecedented precision and efficiency in diagnosis and treatment. Yet, amidst this surge of scientific innovation, the timeless art of medicine (compassion and caring) remains a foundational aspect of patient-centered health care ... The acronym CARE (compassion, assistance, respect, and empathy) encapsulates these enduring values. ... In a world increasingly driven by data and algorithms, these qualities foster a trusting and supportive relationship between health care professionals and patients, thereby enhancing the healing process and enriching the overall health care experience.

[Psychology Today] Facing Mortality Honestly Psychology today, by Patricia Prijatel; 4/6/24 Personal Perspective: Being Mortal, by Atul Gawander, explores end-of-life-care. I read Being Mortal by Atul Gawande when it was first published in 2014 and haven’t stopped talking about it. It shot to the top of my list as one of the most important books I’ve ever read. After 10 years, I read it again to see if it held up. It did. I was as entranced the second time as the first—even more so because, as it happens, I am also now 10 years older.

Chicago area nurse gets 2 years in prison for stealing morphine from sick patientsCBS News TV 2, Chicago; by Acacia Hernandez; 4/4/24A northwest suburban nurse was sentenced in court on Thursday to two years in federal prison for stealing morphine from her patients, some of whom were terminally ill. Sarah Diamond, 31, of Woodstock, was accused of targeting the most vulnerable, including hospice patients living out their final days. In 2021, she removed liquid morphine from bottles that had been prescribed to at least five hospice patients and replaced it with saline. Prosecutors said she took the medication for her own personal use.

Optimizing RN responsibilities ‘more essential’ than staffing hours: study McKnights Long-Term Care News, by Josh Henreckson; 4/2/24 ... [New] analysis suggests that optimizing the role of registered nurses would be an even more effective way of increasing quality of care. Care quality would strongly benefit from an industry-wide focus on the responsibilities of RNs, the study’s authors said. Specifically, leaders should more actively differentiate RNs from licensed practical nurses, use a nursing practice model framework to maximize the role of RNs and provide RNs with more education in leadership and geriatric care.

The iconic stethoscope is getting a 21st century makeoverManaged Healthcare Executive, by Peter Wehrwein; 4/4/24 Two years ago, a pair of New Zealand physicians wrote an opinion piece in a peer-reviewed journal of the Royal Australasian of Physicians about point-of-care ultrasound. The gist of their argument was that ultrasound ought to be used more routinely to detect various heart and lung conditions. The somewhat cheeky title of that article is “Update on Echocardiography: Do We Still Need a Stethoscope?” Jason Bellet has spent more than a decade making pretty much the opposite case: Not only do healthcare professionals still need a stethoscope, they need a vastly improved, 21st century version that harnesses digital technology and artificial intelligence (AI).

Neuropsychiatric effects associated with opioid-based management for palliative care patients

RNs are moving away from home health and hospice, federal survey reveals McKnights Home Care, by Adam Healy; 4/2/24 Though the number of registered nurses continues to grow, fewer are working in home healthcare and hospice compared to years past, according to the latest national sample survey collected by the Health Resources & Services Administration. In 2018, there were 179,509 RNs working in home health and hospice, representing about 6% of the nursing workforce, according to an earlier national survey. HRSA’s latest count estimated that there were 173,808 RNs in home health and hospice in 2022, or only 5% of the workforce. 

Blue Shield's Palliative Care Program wins national recognition for improving lives Blue Shield California; 3/28/24 During the first quarter of this year, the Journal of Palliative Medicine published results of a study entitled “Cost and Utilization Implications of a Health Plan’s Home-Based Palliative Care Program” from leaders at Blue Shield and researchers from West Health Research Institute that garnered attention from industry publications. ...  Major findings from the study were that home-based palliative care delivered to people not yet eligible for hospice reduced their hospital and emergency room use, showed trends towards an increased length of life, and extended the continuum of care for people with serious illness and their caregivers.

Ethical conflicts: Making care decisions when the right choice isn't clear Medical Economics, by Jeff Bendix; 3/29/24 What should a physician do when their ethical training conflicts with the circumstances or needs of a particular situation or patient? ... Ethical battlegrounds are growing. [Dr. Melissa] Lucarelli’s experience epitomizes, in a small way, a problem with which doctors have grappled for as long as medicine has existed as a profession: what to do when their ethical training conflicts with the circumstances or needs of a particular situation or patient. That question has taken on new urgency in recent years due to several converging trends. 

Should we be using palliative care for scleroderma? The Medical Republic, by Karina Bray; 4/2/24Almost three-quarters of systemic sclerosis patients could benefit from specialist palliative care, according to Australian research. The first-of-a-kind study, published in Arthritis Care & Research, set out to examine and quantify the need for palliative care to address high symptom burden as an integrated part of systemic sclerosis management. ... “Almost 75% of SSc patients may benefit from specialist palliative care input to manage specific severe symptoms, and the overlapping nature of such symptoms highlights the complex symptom management needs of SSc patients,” the authors wrote. 

Palliative and hospice care in hospitals and clinics: the good, the bad, and the ugly MedPageToday's KevinMD.com; by Earl Stewart, Jr., MD and Miguel Villagra, MD; 4/1/24 I walk into the patient’s hospital room during evening rounds. He looks pale and tired, having recently completed a round of chemotherapy for his stage IV pancreatic cancer. His wife is at the bedside, scared and concerned about her husband’s rapid decline. I sit down to discuss goals of care when the patient immediately says, “I can’t do this anymore.” His wife responds immediately to the patient: “Of course you can.” ...

UT Tyler School of Medicine receives $400k gift from anonymous donor [for hospice and palliative medicine fellowship] The Gilmer Mirror; 4/1/24The University of Texas at Tyler School of Medicine received a  $400,000 gift from an anonymous donor to support the hospice and palliative medicine  fellowship. The purpose of the gift is to retain physicians in the East Texas region. 

Interruptions: Bad for hospitalists and their patientsThe Hospitalist, by Larry Beresford; 4/1/24More than 10 years ago this magazine published an article by Winthrop Whitcomb, MD, MHM, a pioneer of hospital medicine and co-founder of the Society of Hospital Medicine, warning of the hazards of workflow interruptions for hospitalists, which he labeled a career satisfaction issue for clinicians but a safety and quality risk for their patients. A decade later, the problem has surely gotten worse as hospital financial pressures and staff shortfalls push caseloads higher and job stresses drive burnout and premature retirement for doctors who have been pulled in too many directions in their work.