Palliative care is the kind of care we all want if we suffer from a serious life-limiting disease or condition, or someone in our family does.  In fact, from the patient and family’s perspective, we would hope that every doctor is trained in palliative care, learning how to work with a team to relieve our physical and psychosocial suffering and to provide emotional and spiritual support.   While we have not reached this goal of ensuring that every physician has this kind of training, palliative care has come a long way toward extending that reach.  And New York state is at the forefront of promoting palliative care education.

In 2007 the New York state legislature took a major step toward promoting the growth of palliative care expertise by passing the Palliative Care Education and Training Act.  The Act authorized the state to spend $4.6 million to advance medical education in palliative care, and established a New York State Palliative Care Education and Training Council.  The Council began its three year term in April 2008, and has been meeting every three months.  I was appointed as one of the 19 Council members.

Our legislative mandate in the Council was to focus exclusively on physician education.  The Council itself is comprised of  professionals in a range of disciplines (the list of Council members can be found in this press release: http://www.nyhealth.gov/press/releases/2008/2008-04-15_palliative_care_ed_and_training_council.htm) and we all felt it was important to include these disciplines in education and training programs even though the training itself would be exclusively for medical students and physicians. Palliative care is itself broadly interdisciplinary, including, according to the National Consensus Project for Quality Palliative Care, the following domains: 

·         Structure and Processes of Care

·         Physical Aspects of Care

·         Psychological and Psychiatric Aspects of Care

·         Social Aspects of Care

·         Spiritual, Religious and Existential Aspects of Care

·         Cultural Aspects of Care

·         Care of the Imminently Dying Patient

·         Ethical and Legal Aspects of Care

The Council settled quickly on the idea of adapting the “faculty scholars” model of leadership training used by the Open Society Institute’s Project on Death in America and created the Palliative Care Physician Educator and Champion Program (PEC Program). Through direct salary support over three years, the PEC Program will invest in high-potential palliative care faculty and clinician educators and their projects and will provide a forum for interaction and collaboration for these individuals.

Our aim is to encourage leadership in palliative care.  By providing three-year salary stipends for these PEC leaders, we will enable them to spend a significant proportion of their time on palliative care education and training, and encourage the spread of quality palliative care practice among diverse populations in the State.  Up to 16 of these PEC awards may be given.

The preparation of this RFA is almost complete.  It will call for applications by physicians, with the support of their home institutions.  Applicants must be motivated to deepen their own knowledge of palliative care, to develop and implement educational programs for medical students and practicing physicians, and to become palliative care educational leaders in their communities and in the State.  The RFA process encourages applicants who serve children, low income populations, minority populations, and other groups traditionally under-served by quality palliative care programs. 

A second RFA will invite health care institutions to apply to become a resource center for palliative care professionals and programs in the state, as well as providing support and mentoring for the leaders selected.  Both RFAs should be ready for public release in summer 2009 with a deadline for responses in fall 2009.  Institutions and professionals who are interested can check for RFA release on http://www.nyhealth.gov/funding/ .  For further information contact Leah Kalm-Freeman, Principal Policy Analyst, NYS Task Force on Life & the Law at (212) 417.5444 or lxk06@health.state.ny.us .

Marsha Hurst, PhD

Member, New York State Palliative Care Education and Training Council.

Faculty and Masters Program Director, Narrative Medicine Program, Columbia University

Research Scholar, Institute for Social and Economic Research and Policy, Columbia University