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WINTER 2011 5 More recently, while attending a meeting at the National Association for Home Care and Hospice (NAHC), this change in attitude was perhaps even more clearly exem-plified. For those unfamiliar with NAHC, it is an organiza-tion primarily composed of home health providers across the country, with increasing representation from hospices and home care agencies offering outpatient palliative care services. The hospice and palliative care compo-nents seemed—to this first-time attendee of their meet-ing—to be relatively recent additions to what has tradi-tionally been an organization devoted to home health. The goal of the NAHC Physician Leadership Forum was to engage internal physician leadership, as well as lead-ership from across many areas of medicine, such as the AMA, the American Medical Directors Association, and the American Academy of Home Care Physicians, in an effort to promote physician involvement in the home care setting. As I listened to several stories of success from other participants, I was struck by how similar these were to the hospice and palliative medicine experience. It also occurred to me that our experience actually repre-sents a fairly mature model of successfully accomplishing many of the goals other organizations are now pursuing. I shared with the group of physician leaders at NAHC that it seemed their vision was one of moving sick patients from the hospital setting to the home setting to better manage their care there, and that achieving this would require a complete change in attitudes and priori-ties. I explained that this is very similar to palliative care, during which patients are commonly moved from inten-sive care units to other settings where more appropri-ate care can be provided based on the patient’s goals. I also asked them to try to think of another field that has evolved and succeeded, in a single decade, from having relatively few inpatient services to offering these same specialty services in more than 60% of all hospitals and more than 80% of hospitals with more than 300 beds. This—as we know—is the evolution of palliative care. I also noted some emerging challenges resulting from this growth, including the lack of an expert work force neces-sary to meet the increasing demand. How our field achieved success is a story too long for my remarks to any of the groups I’ve had the pleasure to meet during this past year and certainly for this column. But it is a story worth telling, analyzing, and spreading. The NAHC physician leadership group is certainly inter-ested and so are many others. I used to joke that I entered hospice and palliative medi-cine because I was inspired by the Timbuk3 song, “The Future’s So Bright, I Gotta Wear Shades.” I don’t mean to minimize the work ahead, but ladies and gentleman, you better have your shades on because our field is now a headliner, having moved from backstage directly into the spotlight. Will we shine brightly, earn good reviews, and remain an audience favorite? That depends on how each of us performs, individually and collectively. It has been an honor to serve as your Academy president during this year of exciting developments for our profes-sion. I look forward to continuing our important work together in the years to come. Colfax Avenue is the longest continuous street in the United States and hosts an annual marathon. VOL. 12

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NYU Langone Medical Center