Don’t treat symptoms, treat the whole person

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Minnesota is a national leader in the burgeoning field of palliative care, a holistic approach to medicine, and should seize its current momentum to strive toward further improvements.

Palliative care is a multidisciplinary field, incorporating traditional medical practices along with spiritual and social support, aimed at minimizing patient discomfort during treatment for serious or chronic conditions.

Palliative treatment has been shown to improve health outcomes. Palliative patients, when compared to traditional patients, report better pain management, a greater sense of well-being and dignity, and care more in line with personal preferences.

Part of the palliative process is discussing clear treatment goals with patients, thus reducing overutilization of unnecessary costly procedures with harsh side effects. An American Medical Association study found palliative patients on average saved between $1696 and $4908 compared to traditional patients. In context, studying one large not-for-profit hospital, the Journal of Palliative Medicine found daily mean costs of patients decreased 33% after receiving palliative intervention.

Minnesota, a regional innovator in the field, was one of only six states given an “A” by the Center to Advance Palliative Care and National Palliative Care Research Center 2011 Report Card; 89% of Minnesota hospitals with 50+ beds had palliative programs, and there were 347 Medicare deaths per certified palliative care physician, the lowest rate in the Midwest. The state’s health care system deserves praise for expediently investing in such effective care, only recognized as an accredited specialty in 2007.

Nevertheless, more can be done. The report also identified that only 37% of hospitals with fewer than 50 beds had palliative units. In 2008, the non-profit group Stratis Health assisted 10 rural communities in developing palliative programs. However, 35 different communities applied to receive aid, meaning 25 were rejected because they weren’t entirely prepared to optimally utilize resources from the initiative.

The state should work to support these remaining communities, whether it be through educating providers on best practices in palliative medicine, assisting communities in appropriating existing resources toward palliative programs, using data to understand specific community needs, or offering direct financial support in order to make foundational investments. Minnesota has made huge strides in palliative care, but we’re far from finished.