Young doctors flock toward new specialty in end-of-life care
Stephanie Harman, MD, FACP Medical Director, Palliative Care Service, and Kavitha Ramchandran, MD, Medical Director, Supportive Oncology, at the Stanford Advanced Medicine Center/Cancer Center on the Stanford campus in Palo Alto, Calif. on Thursday, Dec. 1, 2011. The pair of doctors specialize in caring for the terminally ill. (Gary Reyes/ Mercury News)As Daniel Shaine approaches the end of his battle with terminal cancer, he is no longer surprised to find a troop of young doctors, some with pregnant bellies or sparkling engagement rings, at his side at the Palo Alto VA hospital.
"Sometimes I muse to myself, I'm old enough to be this person's father," said Shaine, 67. "I try to push that away."
Increasingly, patients at the end of their lives are talking about end-of-life decisions and do-not-resuscitate orders with doctors on the brink of giving birth. These freshly minted physicians are among a new wave of specialists in the growing field of palliative medicine.
Since medical boards only started recognizing the treatment of pain and end-of-life care as an official subspecialty four years ago and new rules effectively bar older physicians from getting certified, the cohort of doctors spearheading palliative-care departments across the country are increasingly in their early- to mid-30s.
The stark generational differences are showing up at hospitals across the country.
"We acknowledge that we are young, and we only have the wisdom that comes with our 30-something years," said Kavitha Ramchandran, 34, an attending physician in the Hospice and Palliative Medicine unit at Stanford Hospital. "I think there's a steep learning curve in this."
Palliative care doctors manage pain, gauging symptoms and prescribing pain medicines that don't conflict with the patient's other medications. But even more so, they spend a lot of time talking with patients and their families about the dying process, discussing end-of-life decisions and coordinating care with other doctors.
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(Gary Reyes/ Mercury News) As Daniel Shaine approaches the end of his battle with terminal cancer, he is no longer surprised to find a troop of young doctors, some with pregnant bellies or sparkling engagement rings, at his side at the Palo Alto VA
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