Keynote: Why palliative care should be part of all family practices

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Dr José Pereira CFPC FMF 2016

Dr José Pereira’s heartfelt keynote address at Family Medicine Forum on Friday, November 11th, highlighted the importance of having all family physicians include palliative care as part of their practices, for the benefit of their patients and themselves.

In describing his own path to becoming a palliative care expert, Dr Pereira recounted an experience with “George,” a patient he treated many years ago in Manitoba. George was dying of cancer and was in constant pain, and had been prescribed a minimal dose of morphine. When Dr Pereira said he could not increase the dose for fear of causing his patient to become addicted, George said, “I hope that one day doctors like you can look after patients like me.”

This encounter led Dr Pereira to seek out training in palliative care, and he was subsequently able to reach out to that patient, ask for a second chance, and care for him until he died.

Dr Pereira said while there are different understandings of physicians’ roles in palliative care, it is a natural fit for family physicians, and he sees it as everyone’s responsibility.

He also pointed out that palliative care is not just for the final weeks or days of life; patients with progressive heart disease, dementia, and other longer-term illnesses benefit from palliative care. He said the World Health Organization defines palliative care as treatment for life-threatening illness, not terminal illnesses.

For family physicians not doing palliative care, Dr Pereira encourages you to ask yourself: Why not?

He said data suggest only 15% to 30% of Canadians who need palliative care have access to it, but if all family physicians engaged in palliative care everyone would have adequate access.

“Take on George’s challenge,” Dr Pereira said. “Take it on and embrace it.”