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The Physician’s Role in Hospice

When I first started out in hospice (almost 15 years ago), the role of the Medical Director was very clear: show up, sign some papers, keep your mouth shut, and get out of the way.

Things have changed dramatically: our doctors have spent the last decade taking on an increasingly vital role in driving our models of care.  At many other community-based hospices, the doctors fall under the old model.

But at Seasons, our doctors have demonstrated leadership in the following ways:

 ■Active teaching at team meetings and in the community

 ■Serving as Executive Director of one of our programs

 ■Keynote lectures at State Hospice organization events

 ■Publications in hospice and other journals

 ■Engaging in local and national research, to improve hospice care across the country

 ■24/7 contact availability

 ■Embracing of new technology

 ■Working with our staff, facilities, and families to find creative ways to serve extremely complex patients who need us at the end of life

 ■Getting to the bedside

 In 2012 and 2013, our doctors look forward to serving more individuals and families as we launch palliative care in many of our sites.

One of the reasons Seasons has grown so rapidly is our Open Access program.  Our Seasons Physicians process these Open Access requests and are excited to take them on, no matter how challenging.  This often involves calling the patients’ referring doctors, working with large hospital teams, coordinating care with our staff, educating our team members, and speaking with insurance companies to get the right medications covered.

And in the end, when that Open Access patient goes home on a ventilator and dies comfortably with his/her family at the bedside, our Seasons physician is often there too, holding the patient’s hand. In fact, our Seasons doctors get to the bedside often.  In some programs, over 75 percent of the new patients are seen by a hospice doctor within 14 days! Our required face-to-face visits are also typically made by our Seasons doctors – and many were doing these visits well before the government made this step mandatory.

Our Seasons doctors help each other out often.  They learn from each other, they share insights, and they teach me something new every time we convene, even via conference call.  This spirit of collaboration among our medical staff is uniquely Seasons, and makes me proud to be a part of it. 

We sure have come a long way in 15 years.

Written by - Balu Natarajan, M.D., Chief Medical Officer, Seasons Hospice & Palliative Care