Educating surgeons for the new golden hours: honing the skills of palliative care.
All surgeons should maintain a lifetime commitment to education and learning. Those who already are in practice need to make the effort to obtain or refresh their education in basic competencies in palliative care and to provide a measured balance between philosophy and practical skills. Many resources and teaching tools are available to assist in this continuing process: surgical peers (and peers from other medical specialties),journals, textbooks, CME conferences, surgical governance and educational organizations, and palliative care websites. A tremendous summary article on palliative care education for surgeons was published recently in JACS[24]. Surgeons must be competent in the following palliative care skills:communication, holistic patient evaluation, control of pain and symptoms,understanding legal/ethical issues, withdrawing care, and the continuum of acute to chronic to terminal care. If they cannot attend to all of these areas individually, they need to be aware of the local, regional, and national resources that are available to assist the patient (or their surrogate decision maker) and themselves in the end-of-life arena. Consultations and referrals should be accomplished in such a manner that the patient does not feel abandoned by his/her surgeon at such a critical point in his/her life. Practicing surgeons also must be involved actively in the education of resident and medical students in didactic and clinical situations. Most importantly, they must model the appropriate behaviors for their charges personally, whether it be in the consultation room breaking bad news compassionately or at the bedside easing the path to the next world. In these golden hours, the educated surgeon who wields new and mighty resources can be the greatest champion of the patient who is at the end of life.
Huffman
Joan L
JL
Department of Surgery, Temple University School of Medicine, 1801 North Broad Street, Philadelphia, PA 19122, USA. lavenderdoc@comcast.net
D002983:Clinical Competence; D003226:Congresses as Topic; D004502:Education, Medical, Continuing; D013502:General Surgery / Q000193:education*; D006801:Humans; D020407:Internet; D007396:Internship and Residency; D007400:Interprofessional Relations; D010166:Palliative Care; D013337:Students, Medical; D013664:Teaching Materials