Hospice news

Results of a national survey appearing in the September 2005 issue of Archives of Surgery indicate that most surgeons lack training in palliative care for cancer patients. Richard J. Bold, MD, and associates at the University of California/ Davis Medical Center surveyed 124 surgeons across the country to determine their experience, training, and attitudes toward palliative surgical management of patients with advanced malignancies. Seventy surveys were returned. “Given the vast differences in recommendations by the surgeons in our sample who were all trying to achieve the same goal,” said Bold, “I think that a standardized curriculum should be developed for educational purposes.” Eighty-four percent of respondents had received no palliative care education during their residencies, while those who did reported a mean length of training of six hours. Excluding seven trainees, slightly more than half of respondents had received additional palliative surgical training through continuing medical education sources. Nonetheless, the median length of career palliative care training was only four hours. With regard to treatment options when provided with four potential clinical scenarios, the respondents chose functional status, expected survival, and potential for pain and symptom relief as factors most influencing palliative treatment decisions. Significantly, no consensus was reached on treatment recommendations in three of the four scenarios. Surgeons who had received training in palliative care were somewhat more likely than other respondents to select surgical palliative interventions for patients in three of the scenarios and were significantly more likely to recommend hernia repair in the fourth scenario. “Education should form the basis of recommendations [for palliative surgical interventions] rather than personal experience,” the authors concluded. (Source: Archives of Surgery, September 2005, pp. 873-880.)