The strong current and future demand for palliative care specialists inspired the CU Anschutz Medical Campus to offer the nation’s first master’s degree in interdisciplinary palliative care.
“We don’t train enough people in palliative medicine and palliative care,” said Amos Bailey, MD, who spearheaded the new program to be housed in the CU Denver | Anschutz Graduate School. “Nationally, we need an additional 5,000 full-time providers.”
Bailey said that number could actually require up to 18,000 trained healthcare professionals, depending on the proportion of time they can devote to hospice and palliative medicine practice.
A patient receiving palliative care from a team of healthcare professionals.
CU’s new graduate-degree program, which expects to launch with 18 students next summer and increase to about 50 in a few years, was approved by the CU Board of Regents in September. The two-year program is a hybrid of classroom and online instruction.
Bailey is an oncologist and became the first internist specializing in palliative medicine at the University of Alabama-Birmingham before coming to CU Anschutz in summer 2014. “I was impressed with how well my patients that I referred to home hospice were doing, how good their symptom-control was,” he said. “I wanted to provide better symptom-control for my patients, but also better support them psychologically and spiritually, so I studied palliative care and brought it into my practice.”
'Very receptive audience'
At CU Anschutz, Bailey met with representatives from the School of Medicine (SOM), College of Nursing (CON), Skaggs School of Pharmacy and Pharmaceutical Sciences and the Graduate School; all were enthused about a palliative care master’s program and contributed startup funds.
Until recently, Bailey said, there has been relatively little formal training for healthcare professionals in palliative care. Historically, providers have offered some palliative medicine and care while devoting the majority of their time to their practice.
“If someone wanted to work in palliative care full time – and it’s likely there is the patient need where they work -- our program can prepare them,” Bailey said. “Even small, rural hospitals have very large coverage areas and could likely support several people providing palliative care.”
Students who complete the first part of the program (12-15 credit hours) will receive a certificate in palliative care. Those finishing the full program will earn a Master of Science in Palliative Care which will prepare healthcare providers – including physicians, nurses, physician assistants and pharmacists – to be Palliative Care Community Specialists.
“I came here with this idea and it met a very receptive audience,” said Bailey, who was recruited to CU’s SOM by Jean Kutner, MD, MSPH, who at the time was the head of the Division of General Internal Medicine and was the founder of CU’s Palliative Care Program. The Board of Regents approved the program and took the added step of granting an expedited start. “That was yet another vote of confidence from the University of Colorado.”
Huge need: secondary palliative care
Bailey noted that CU already embeds palliative medicine and care principles into basic curriculum in SOM, CON and the Skaggs School of Pharmacy and Pharmaceutical Sciences. Students who go on to the M.S. in Palliative Care will receive much more in-depth training to become specialists in the area.
The workforce shortage is most profound in secondary palliative care, Bailey said. Primary care involves basic palliative skills that all providers should have. Tertiary care is available at academic medical centers such as the CU Anschutz Medical Campus where specialist knowledge for the most complex cases is practiced, researched and taught.
Secondary palliative care encompasses specialist clinicians and organizations that provide specialty care and consultation.
“The students in our program would fill that need for secondary palliative care,” Bailey said. “Let’s say the hospital in Cody, Wyo., wants to improve palliative care service, but they don’t have the resources for a full-time person. We’re hoping someone there who has a heart for this would see this as a way of improving their skills and their training.”
Palliative Care Community Specialists will be linked to tertiary care experts through a comprehensive educational program, creating a network of palliative care services to better support the needs of patients and families across the continuum of illness and venues of care.
Backed by research
Bailey said the effectiveness of palliative care specialists is backed by research, including the 2014 Institute of Medicine (IOM) report, “Dying in America.” In randomized control trials, lung-cancer patient groups that received palliative care consultation reported 50 percent less pain and depression and were less likely to die in a hospital or intensive-care unit. Also, the consulted patients lived three months longer than the group that didn’t receive palliative care.
“So it appears that patients with good physical pain control and psycho-social-spiritual care are better able to tolerate and benefit from disease-modifying treatment,” Bailey said.
Bailey used blogs and social media outreach to gauge potential student interest in a palliative care specialist program. “We had 575 responses in 20 days and three-fourths of people said they were interested or very interested,” he said. “Half of the respondents thought their employers would help with tuition costs. So this could definitely be a way to help address the palliative care workforce need.”