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Readying Palliative Care for a Paradigm Shift









 
 

Readying Palliative Care for a Paradigm Shift


Mary Beth Morrissey, Ph.D., is spearheading a two-weekend intensive certificate program that brings together social workers, nurses, and doctors.

Photo by Tom Stoelker

A new certificate program in palliative care being offered at Fordham Westchester encourages workforce readiness and early planning with health care professionals, in lieu of last minute decision-making.

With the support of the Graduate School of Business Administration’s (GBA) Global Healthcare Innovation Management Center, and its director Falguni Sen, Ph.D., the Westchester-based Collaborative for Palliative Care will run an intensive two-weekend certificate program this summer and next fall.

“One of the big issues is communication,” said Mary Beth Morrissey, Ph.D., FCRH ’79, LAW ’82, GSS ’11. “Patients and families don’t understand and are often not informed about their palliative care options that are being embedded in the health care structure.”

As a fellow of the center, Morrissey has been leading roundtable discussions about health care reform. With her background in law, policy, and social science research, Morrissey spearheaded the cross-disciplinary program, which brings together nurses, social workers, psychologists, doctors, business owners, and managers in the same classroom.

The program will introduce students to the various aspects of palliative care, including: a public health approach to health care management, the legal and ethical consensus in end-of-life decision making, meanings of patient suffering from a human science perspective, new systems of care, policies and protocols in palliative medicine, clinical management of pain, advance care planning, models of financing, and the role of ethics committees in conflict negotiation.

Morrissey said that after the latest health care debate there’s a consensus that “we need to change the way we do business.” Early palliative care intervention would help drive down costs by allowing patients and their families to understand their illness trajectories and help them access care that will improve quality of life, instead of relying on marginally beneficial tests and procedures that may prolong suffering and be unlikely to improve patient outcomes.
Because palliative care has not yet become mainstream, it is often shunted to the sidelines as doctors and patients soldier on when they should be talking about best management of the advanced illness.

“People are living longer with chronic illness,” said Morrissey. “We see multiple co-morbidities, like chronic cancer, diabetes, and advanced dementia in the same patient.”

American culture in general has a problem accepting any limits on care, she said. The language of Western individualism, patient rights, and autonomy, has made little space for engaging in conversations about future health care needs, values, and care preferences.

But it’s not just the culture at large that has a problem with human finitude, said Morrissey. Doctors trained to prolong life, such as oncologists, rarely make referrals to palliative care.

Morrissey has led five annual conferences that have provided a platform for mobilizing resources, especially at the local level. She continues to encourage interdisciplinary training and education that bring together law, policy, and social science research to strengthen the health care workforce. The certificate program will build on these initiatives.

“Participants in the certificate program will understand that palliative care is an effective medical and business model, and holds great promise as a social model,” she said.

— Tom Stoelker

 

 


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