When Dr. Paul Tatum’s father was dying several years ago from an extraordinarily rare disease that caused, among other things, weakness and severe shortness of breath, the hospital team did not have the skills to alleviate his suffering.
Believing they couldn’t “give him morphine because it might kill him,” the hospital was powerless to ease his suffering, yet eager to provide intensive care. “It’s sad the team was afraid of killing him with the use of morphine when that is the one intervention from which he would have most benefited,” Dr. Tatum says.
Dr. Tatum, who had training in primary care and geriatrics, along with some experience in hospice, resolved to provide a better end-of-life experience for patients.
“That’s when I decided that palliative care was what I really wanted to do,” he says.
And, indeed, he has.
Dr. Tatum, medical director for the Compassus program serving the JeffCo area in Mid-Missouri and Program Director of the Hospice and Palliative Medicine Fellowship at the University of Missouri, recently won the 2016 Hastings Center Cunniff-Dixon Mid-Career Physician Award. The award honors physicians who have shown exemplary care for their patients and who have enhanced end-of-life care as a basic part of the doctor-patient relationship. He is also a member of the Compassus Medical Directors Advisory Council.
Dr. Tatum, MD, MSPH, CMD, FAAHPM, has held various medical and teaching positions, and developed national curriculum with the AAHPM and CAFP to redefine palliative medicine for primary care physicians.
But there’s still a lot of work to be done, he says.
“The region where you die determines what choices you have,” he explains. “If it’s a region where there are lots of ICU beds, then you’ll have an ICU end of life. If it’s a region where palliative care is the norm, then you’ll have that, along with earlier access to hospice.”
Unfortunately, the idea of palliative care is relatively new enough that most physicians don’t know what it is, Dr. Tatum says.
“The tragedy of that is, if you tell patients and families what palliative care is, they say they want it,” he says. “It’s exactly what patients need when there is serious illness.”
And effective palliative care results in a better hospice experience for patients and their families, he says.
“If we create a culture of early access to palliative care for serious illness, then (the situation of) people being in hospice for only three to five days will end,” he says.
Entering hospice earlier will provide hospice care teams more time to build trust and relationships with patients and their families, Dr. Tatum says, so that the end-of-life experience is peaceful and not what his family experienced with his father’s death.