Expanding Palliative Care: Changes in Society and in the Journal

Palliative care continues to grow and gain acceptance as an important alternative to curative when cure appears futile throughout the United States and many other countries. Hospices, which have grown from one program in Connecticut 1975 to over 3,000 programs in all of the states just a quarter of a century later, remain the principle providers of palliative care. But increasing numbers of hospital and long-term care facility palliative care programs and even academic and hospital departments of pain medicine and palliative care have been established. Both the American Academy of Hospice and Palliative medicine and the Association of Hospice and Palliative Care Nurses continue to grow and credential more physicians and nurses as palliative care providers. The Board of Pharmaceutical Specialties is examining the possibility of creating a bard specialty for palliative care pharmacists. Palliative care has grown well beyond the provision of symptom control at the end of life. Integrated palliative care programs now function within curative care settings. This writer strongly believes that palliative care should be initiated at the time of diagnosis of a potentially life-limiting disease, not just after attempts at cure have failed. I recently learned that in Mexico, pain medicine and palliative care are a single specialty. Physicians being trained in pain management are concurrently trained in palliative care. While specialty palliative care society meetings are the major venues for presentation on symptom control in advanced disease, the quantity and quality of papers relating to palliative care are being presented at pain society meetings. Pain management and palliative care have many common feature and share a body of literature. But there are unique aspects to each. One field often provides useful ideas and clinical strategies to the other. There is value in cross training and sharing of ideas among pain and palliative care clinicians. This Journal is committed to supporting such sharing. Effective with Volume 10 next year, the Journal of Pharmaceutical