KS-012049 eCQ 11-1 Newsletter
A Lack of Training in Palliative Care Linked to More Aggressive Treatment Recommendations by Surgeons
a large urban area in 2017. Participants reported the extent of their PC training, including structured training during residency and fellowship as well as continuing medical education and self-directed learning. Participants were then presented with four clinical vignettes involving patients with stage IVcancer, and asked to select and justify their treatment decisions. KEY FINDINGS • Surgeons reported fewer hours of PC training (median, 10 hours) compared with medical oncologists (median, 30 hours) and medical intensivists (median, 50 hours). • 20%of surgeons had no PC training at all. All medical oncologists reported some PC training; only one intensivist reported no PC training. • In the four clinical scenarios, respon-
Physicians with no training in pallia- tive care (PC) were significantly more likely than those with such training to recommendmajor surgical interventions for patients with advanced cancer, a re- cent survey has found. Further, surgeons in the survey had the fewest hours of PC training and the highest percentage (20%) of no training, according to a report published in Surgery. “Surgeons must weigh the surgical risks with the potential palliative ben- efits, knowing that operative complica- tions may impact patients’quality of life profoundly,” write the authors. Investigators analyzed questionnaire responses of surgeons, medical oncolo- gists, and intensivists (n = 102; median years in practice, 14) treating advanced cancer patients with symptomatic surgi- cal conditions in a diverse number of hospitals and physician practices within
dents with no PC training recom- mended major surgical interventions significantly more frequently com- pared with those with ≥ 40 hours of PC training (1.6 ± 0.8 vs 0.7 ± 0.7; P = 0.01). “These findings highlight the need for greater efforts system-wide in pal- liative care education among surgeons, including incorporation of a structured palliative care training curriculum in graduate and continuing surgical educa- tion,” conclude the authors. Source: “Palliative Care Training and Decision- Making for Patients with Advanced Cancer: A Comparison of Surgeons and Medical Physicians,” Surgery; Epub ahead of print, April 27, 2018; DOI: 10.1016/j.surg.2018.01.021. Bateni SB et al; Division of Surgical Oncology, Department of Surgery; and Division of Trauma, Acute Care Surgery, and Surgical Critical Care, University of California, Davis Medical Center, Sacramento.
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