AAHPM — Winter Quarterly 2011
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AAHPM NEWS
Hospice Medical Director Certification
In 2008, the Board of the American Academy of Hospice and Palliative Medicine charged the Medical Director Education Committee to work with staff and consultants in evaluating and possibly implementing a new Hospice Medical Director (HMD) Certification. As envisioned, this would be entirely distinct from the American Board of Medical Specialties and the American Osteopathic Association sub-specialty certifications for hospice and palliative medicine. The goals of this certification would be to improve the quality and consistency of physician practice within hospice and to promote a professional vision for physicians who do this work. The AAHPM board has now approved a plan for a nonprofit certifying body, which will be known as the National Board for Hospice Medical Director Certification (NBHMDC).
A multiyear process included a needs assessment, review of existing organizations, and series of analyses with consultant input. As it occurred, the Committee worked with staff to propose paradigms for key content and competency evaluation.
The NBHMDC will begin by organizing a board that will allow incorporation and development of a governance structure. This board will also review proposals from potential testing vendors and work with the selected vendor to develop the certification process based on the recommendations of the Medical Director Education Committee.
The AAHPM board hopes that certification for HMDs will help expand a committed physician workforce capable of addressing an intensifying focus on quality care. The certification will help guide the professional growth of the many HMDs who work part time in hospice programs, and provide a framework for advanced training in the core clinical knowledge for HMDs and the regulatory and administrative expertise necessary for this role. It can help even those who are board certified in hospice and palliative medicine focus on continuing education efforts that will prepare a physician for a primary role as an HMD.
The NBHMDC’s goal is to begin certifying hospice medical directors in 2013. More details are available at aahpm.org.
AAHPM Discusses Prescriber Education with ONDCP
Gil Kerlikowske, director of the Office of National Drug Control Policy (ONDCP), spoke to attendees at the American Medical Association (AMA) Interim Meeting on November 14 to discuss the Obama Administration’s action plan to address the nation’s prescription drug abuse epidemic. Overdose deaths resulting from the nonmedical use of prescription painkillers have more than tripled in the past decade. In response, the plan includes support for the expansion of state-based prescription drug monitoring programs, more convenient and environmentally responsible disposal methods to remove unused medications from the home, education for patients and healthcare providers, and support for law enforcement efforts that reduce the prevalence of “pill mills” and doctor shopping.
Director Kerlikowske invited AAHPM’s AMA delegation to meet one on one with him and ONDCP’s policy director Regina LaBelle to discuss the issue of prescriber education. The US Food and Drug Administration’s Risk Evaluation and Mitigation Strategies (REMS) for long-acting opioids requires prescriber education, and the Administration is considering amending federal law to require practitioners (physicians, dentists, and others authorized to prescribe) who request Drug Enforcement Administration registration to prescribe controlled substances to be trained on responsible opioid prescribing practices as a precondition of registration.
The Academy’s AMA delegate Chad Kollas, MD FACP FCLM FAAHPM, and alternate Dennis Pacl, MD FACP, along with AAHPM’s delegate to the AMA’s Resident and Fellow Section, Patrick White, MD, and Director of Health Policy and Government Relations, Jacqueline M. Kocinski, MPP, shared concerns that efforts to stem the abuse/misuse of prescription drugs do not impede access for patients with legitimate need for them. They discussed how strategies such as mandating informed consent by the patient or patient treatment agreements would not make sense for all hospice and palliative medicine patients and stressed that even a basic prescriber/ dispenser education curriculum should address special populations. They also offered for AAHPM to serve as a resource as ONDCP implements its action plan, to help ensure efforts are focused appropriately and consider patients with serious illness and at the end of life.
AAHPM Fellowship Program Grants Continue to Help the Field Grow
As reported in the summer 2011 issue of AAHPM Quarterly, The Hearst Foundations awarded the Academy $1.2 million in funding for palliative medicine fellowship training programs over a 3-year period. In each of the 3 years, AAHPM will award up to 10 1-year, $37,750 Hearst Foundations Aging Initiative Fellowship Grants to accredited fellowship programs that meet the award criteria. These programs must be committed to matching the amount of funding awarded focused on training physicians interested in caring for the aging and to developing leaders who will integrate palliative care into the training of students and residents as they prepare for careers as internists, family physicians, surgeons, and other physician specialists.
Task force members who were charged with managing the process and distribution of awards were selected based on their thorough knowledge of fellowship program development and representation of hospice and palliative care programs of diverse sizes, maturity, geographical locations, and structures. Eligibility criteria and funding priorities for the awards were established during summer 2011. The task force then solicited and reviewed applications from 26 programs, or one-third of all accredited hospice and palliative medicine training programs in existence. In November, following a comprehensive review process, the following programs were selected to receive the initial 10 awards supporting training programs for the 2012-2013 academic year:
Duke University
Mount Sinai School of Medicine
Northwestern University
San Diego Hospice & the Institute for Palliative Medicine/
Scripps Mercy Hospital
Summa Health System
University of Alabama at Birmingham
University of Chicago
University of Colorado Denver
University of Rochester Medical Center
University of Texas Health Science Center at San Antonio
AAHPM remains committed to developing a sustainable and well-trained physician work force that ensures all patients have access to quality palliative care across every healthcare setting. The Hearst Foundations have provided the means to support that goal. The Academy will continue to identify other partners who share an interest in advancing the critical goals and needs of AAHPM’s membership.
More information regarding the second year of the Hearst Foundations Aging Initiative Fellowship Grants will be posted at aahpm.org when details are finalized.
Register Now to Attend Assembly Sessions of Interest
Nowhere else but at the 2012 AAHPM & HPNA Annual Assembly can you find content specific to your work, including cutting- edge ideas and research. Presentations will be given by some of the brightest minds in hospice and palliative medicine.
This year’s Annual Assembly promises to deliver more educational content than ever before, with additional sessions added. Below are just a few of the sessions on the agenda for March. Visit AnnualAssembly.org to download a PDF of the conference brochure with a full listing of sessions.
∙ Beyond Gender: Ways Men and Women Cope with Illness and Grief
∙ Second Victims: Why Palliative Care Should Recognize and Help Staff Who Are Adversely Impacted by Difficult Cases
∙ Bending the Cost Curve: A Lively Panel Discussion
∙ “The Dog Ate My Methadone”: Challenges Treating Patients with Advanced Illness, Pain, and Addiction
∙ Sex, Drugs, and Rockin’ Chairs: Palliative Care Assessment of the Taboo. Are We Doing Enough?
∙ “More Fun Stuff”: Regulatory Boot Camp for Hospice Physicians Part B
∙ OMG RUS (Oh My God, Are You Serious?): Talking with Teens About Dying
∙ Speed Dating with Pharmacists: 50 Practical Medication Tips at End of Life
∙ Visitor in a Foreign Land: Consultation Etiquette in the Emergency Department
In 2008, the Board of the American Academy of Hospice and Palliative Medicine charged the Medical Director Education Committee to work with staff and consultants in evaluating and possibly implementing a new Hospice Medical Director (HMD) Certification. As envisioned, this would be entirely distinct from the American Board of Medical Specialties and the American Osteopathic Association sub-specialty certifications for hospice and palliative medicine. The goals of this certification would be to improve the quality and consistency of physician practice within hospice and to promote a professional vision for physicians who do this work. The AAHPM board has now approved a plan for a nonprofit certifying body, which will be known as the National Board for Hospice Medical Director Certification (NBHMDC).
A multiyear process included a needs assessment, review of existing organizations, and series of analyses with consultant input. As it occurred, the Committee worked with staff to propose paradigms for key content and competency evaluation.
The NBHMDC will begin by organizing a board that will allow incorporation and development of a governance structure. This board will also review proposals from potential testing vendors and work with the selected vendor to develop the certification process based on the recommendations of the Medical Director Education Committee.
The AAHPM board hopes that certification for HMDs will help expand a committed physician workforce capable of addressing an intensifying focus on quality care. The certification will help guide the professional growth of the many HMDs who work part time in hospice programs, and provide a framework for advanced training in the core clinical knowledge for HMDs and the regulatory and administrative expertise necessary for this role. It can help even those who are board certified in hospice and palliative medicine focus on continuing education efforts that will prepare a physician for a primary role as an HMD.
The NBHMDC’s goal is to begin certifying hospice medical directors in 2013. More details are available at aahpm.org.
AAHPM Discusses Prescriber Education with ONDCP
Gil Kerlikowske, director of the Office of National Drug Control Policy (ONDCP), spoke to attendees at the American Medical Association (AMA) Interim Meeting on November 14 to discuss the Obama Administration’s action plan to address the nation’s prescription drug abuse epidemic. Overdose deaths resulting from the nonmedical use of prescription painkillers have more than tripled in the past decade. In response, the plan includes support for the expansion of state-based prescription drug monitoring programs, more convenient and environmentally responsible disposal methods to remove unused medications from the home, education for patients and healthcare providers, and support for law enforcement efforts that reduce the prevalence of “pill mills” and doctor shopping.
Director Kerlikowske invited AAHPM’s AMA delegation to meet one on one with him and ONDCP’s policy director Regina LaBelle to discuss the issue of prescriber education. The US Food and Drug Administration’s Risk Evaluation and Mitigation Strategies (REMS) for long-acting opioids requires prescriber education, and the Administration is considering amending federal law to require practitioners (physicians, dentists, and others authorized to prescribe) who request Drug Enforcement Administration registration to prescribe controlled substances to be trained on responsible opioid prescribing practices as a precondition of registration.
The Academy’s AMA delegate Chad Kollas, MD FACP FCLM FAAHPM, and alternate Dennis Pacl, MD FACP, along with AAHPM’s delegate to the AMA’s Resident and Fellow Section, Patrick White, MD, and Director of Health Policy and Government Relations, Jacqueline M. Kocinski, MPP, shared concerns that efforts to stem the abuse/misuse of prescription drugs do not impede access for patients with legitimate need for them. They discussed how strategies such as mandating informed consent by the patient or patient treatment agreements would not make sense for all hospice and palliative medicine patients and stressed that even a basic prescriber/ dispenser education curriculum should address special populations. They also offered for AAHPM to serve as a resource as ONDCP implements its action plan, to help ensure efforts are focused appropriately and consider patients with serious illness and at the end of life.
AAHPM Fellowship Program Grants Continue to Help the Field Grow
As reported in the summer 2011 issue of AAHPM Quarterly, The Hearst Foundations awarded the Academy $1.2 million in funding for palliative medicine fellowship training programs over a 3-year period. In each of the 3 years, AAHPM will award up to 10 1-year, $37,750 Hearst Foundations Aging Initiative Fellowship Grants to accredited fellowship programs that meet the award criteria. These programs must be committed to matching the amount of funding awarded focused on training physicians interested in caring for the aging and to developing leaders who will integrate palliative care into the training of students and residents as they prepare for careers as internists, family physicians, surgeons, and other physician specialists.
Task force members who were charged with managing the process and distribution of awards were selected based on their thorough knowledge of fellowship program development and representation of hospice and palliative care programs of diverse sizes, maturity, geographical locations, and structures. Eligibility criteria and funding priorities for the awards were established during summer 2011. The task force then solicited and reviewed applications from 26 programs, or one-third of all accredited hospice and palliative medicine training programs in existence. In November, following a comprehensive review process, the following programs were selected to receive the initial 10 awards supporting training programs for the 2012-2013 academic year:
Duke University
Mount Sinai School of Medicine
Northwestern University
San Diego Hospice & the Institute for Palliative Medicine/
Scripps Mercy Hospital
Summa Health System
University of Alabama at Birmingham
University of Chicago
University of Colorado Denver
University of Rochester Medical Center
University of Texas Health Science Center at San Antonio
AAHPM remains committed to developing a sustainable and well-trained physician work force that ensures all patients have access to quality palliative care across every healthcare setting. The Hearst Foundations have provided the means to support that goal. The Academy will continue to identify other partners who share an interest in advancing the critical goals and needs of AAHPM’s membership.
More information regarding the second year of the Hearst Foundations Aging Initiative Fellowship Grants will be posted at aahpm.org when details are finalized.
Register Now to Attend Assembly Sessions of Interest
Nowhere else but at the 2012 AAHPM & HPNA Annual Assembly can you find content specific to your work, including cutting- edge ideas and research. Presentations will be given by some of the brightest minds in hospice and palliative medicine.
This year’s Annual Assembly promises to deliver more educational content than ever before, with additional sessions added. Below are just a few of the sessions on the agenda for March. Visit AnnualAssembly.org to download a PDF of the conference brochure with a full listing of sessions.
∙ Beyond Gender: Ways Men and Women Cope with Illness and Grief
∙ Second Victims: Why Palliative Care Should Recognize and Help Staff Who Are Adversely Impacted by Difficult Cases
∙ Bending the Cost Curve: A Lively Panel Discussion
∙ “The Dog Ate My Methadone”: Challenges Treating Patients with Advanced Illness, Pain, and Addiction
∙ Sex, Drugs, and Rockin’ Chairs: Palliative Care Assessment of the Taboo. Are We Doing Enough?
∙ “More Fun Stuff”: Regulatory Boot Camp for Hospice Physicians Part B
∙ OMG RUS (Oh My God, Are You Serious?): Talking with Teens About Dying
∙ Speed Dating with Pharmacists: 50 Practical Medication Tips at End of Life
∙ Visitor in a Foreign Land: Consultation Etiquette in the Emergency Department
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