Literature Review

A doctor’s tumor rupture upends all she thought she knewMedscape Nurses; by Rana Awdish as told to Sarah Yahr Tucker; 3/17/25At some point, every doctor becomes a patient. For many physicians, experiencing serious illness and treatment is humbling, eye-opening, and, in the end, transformative. Dr. Patient is a Medscape series telling these stories... I was 7 months pregnant and it was my last day of fellowship. I went to dinner with my best friend to celebrate, and at the table I had excruciating abdominal pain that led me to present to my hospital. I didn’t know yet, but I had a noncancerous tumor in my liver that ruptured... There’s a lot of good evidence that when physicians communicate with empathy, a patient is less likely to come back to the ER for the same complaint... It’s as effective as any drug we have. I learned this from one of the surgeons who operated on me... He looked at me and said, “I want you to tell me what you’re most afraid of.” I said, “I’m afraid of having an ostomy bag when I leave the operating room.” And he said, “I can’t tell you how much I don’t want that to happen to you. I’m going to do everything I can to make sure that doesn’t happen.” With that one question and answer, I understood that our work for our patients is to hold their fear. I didn’t know that my fear couldn’t be bludgeoned to death with data. I thought if I had the right data, I would feel better. But nothing was ever going to make that better except him acknowledging my fear and holding it for me.Publisher's note: I recently experienced how healthcare, including hospice, is very different when we are the patient - or in my case, the son. So much to be thankful for; so much to learn. Also see the author's article Never-Words: What not to say to patients with serious illness.

Researchers raise concerns about the financial sector's rising role in US illness care Medical Xpress; by Mary Ann Liebert, Inc; 10/16/24 The authors of a new article in Journal of Palliative Medicine state that the "growing role of the financial sector in home health and hospice, a reflection of larger trends in U.S. health care, is concerning and has major implications for care quality unless reforms are undertaken." Co-authors Lauren Hunt, Ph.D., RN, FN, with the University of California, San Francisco, and R. Sean Morrison, MD, with the Icahn School of Medicine at Mount Sinai in New York, observe that home health and hospice began as nonprofit organizations with close ties to their communities. However, the overwhelming majority are now for-profit entities, many of which have become targets for private equity buyouts. The authors note that "big business's emphasis on maximizing profit can be at odds with patient welfare. Indeed, a substantial body of evidence now demonstrates that care quality is consistently worse in for-profits as compared to nonprofits," they state. The authors further express concern that "pressure to achieve high returns on very short-term time horizons may conflict with the need for longer-term investments in quality, training, and staffing, thus reducing care quality.Publisher's note: I suspect this will be the next "big" article summarizing the role of private equity in hospice.