Aaron Lyss and Natalie R. Dickson, MD, CMO for Tennessee Oncology
A recently published study analyzed the differences in two different patient groups’ respective perceptions of the care they received: (1) a cohort of patients that received cancer care with concurrent palliative care; and (2) a cohort of patients who received cancer care without palliative care. Further details pertaining to the study can be found at the link at the end of article.
Patient perceptions of the care they received during the study were analyzed according to three domains: (1) perceived differences between oncologists and palliative care specialists in the focus of care; (2) perceived differences between oncologists and palliative care specialists in the care delivery model that patients experienced; (3) the extent to which care provided by oncologists and palliative specialist care was seen by patients as complementary.
| Domain | Oncologist-directed care | Palliative specialist-directed care |
| Focus of care? | disease-centered, with emphasis on controlling disease, and increasing survival | Holistic with emphasis on symptom management |
| Care delivery model? | Physician visits that are structured, physician-led, time constrained | Fluid, patient-led, flexible |
| Complementary care? | Oncologist and palliative specialist directed care were seen as complementary by patients who had access to both types of specialists. | |
The results of this study are consistent with the rationale for the palliative care partnership that Tennessee Oncology formed with Aspire Health. Through this partnership (currently in place at St. Thomas West and CMC, and soon to expand to Memorial and other Tennessee Oncology facilities) Aspire Health can place palliative specialists on-site in Tennessee Oncology facilities. Physicians throughout all Tennessee Oncology sites can refer patients to palliative care specialists by having their staff call the front desk at the facilities where Aspire practitioners are located
By enhancing access to palliative specialists, we can offer our patients the benefits of this integrated multi-disciplinary approach to delivering the best possible patient experience. In addition, referring patients to palliative care in the early stages of treatment will facilitate higher performance for our practice in various quality programs in which we participate, including Medicare’s Oncology Care Model, the Aetna Medical Home Program, and the ASCO Quality Practice Initiative. For example, according to a study published in January of 2016 in Health Affairs, access to palliative care for cancer patients with multiple chronic conditions was associated with higher quality care and lower total costs of care, and the impact of palliative care was more dramatic for patients with higher numbers of chronic comorbidities.
For more in-depth background to this article: “Early Palliative Care and Its Role in Oncology: A Qualitative Study.”
