UCSF Palliative Care Program, San Francisco
UCSF Palliative Care Program website
Joseph Prevratil, President and CEO, Archstone Foundation
Dr. Robert M. Wachter, Professor and Chief Division of Hospital Medicine, University of California, San Francisco
Dr. Steven Pantilat is fostering a new approach to caring for patients with life-threatening illnesses based on matching treatments to patients’ true goals, improving their quality of life and supporting them and their loved ones.
When Steven Pantilat was in medical school, he was shaken to watch doctors give repeated blood transfusions to a young mother who was dying of leukemia, rather than tell her the truth about her illness and give her the choice of spending her last days at home with her two-year-old daughter.
Sadly, that patient was no exception. More than half of all Americans who die each year, including some 125,000 Californians, do so in hospitals, while often enduring painful, costly, and unwanted procedures. Pantilat, who today is an internist and researcher at the University of California, San Francisco, thinks society can do better. For the past 12 years, he has championed palliative care, which aims to restore realism to doctor-patient relations and relieve physical and emotional suffering.
Typically, medicine is focused on treating disease and extending lives at all costs. What is different about palliative care is the recognition that sometimes those aren’t the right goals for the patient. Rather than focusing on a disease that needs treatment, palliative care focuses on the needs of the person and giving them high quality, individualized care that is more in line with what they and their families want.
Dr. Pantilat explains, "Instead of a 'one size fits all' approach to medicine, we need to match treatments to a person's values and preferences."
Pantilat has trained 180 teams of doctors, nurses, chaplains, and social workers throughout the country to meet with patients and their families from the time they are diagnosed with a life-threatening illness to the end of their lives. More than 140 of these groups are now operating in hospitals, where they tend to as many as 35,000 patients a year.
A growing body of evidence points to the benefits of this approach. Recent studies show patients who received palliative care were less depressed and more satisfied with their care than those who received traditional care. It has even helped patients live up to 25 percent longer, according to a recent study in the New England Journal of Medicine.
"Palliative care should be a standard part of medicine, in every insurance plan and every hospital," Pantilat says.
At the same time, palliative care is often healthier for the patient’s family members, who are at greater risk of depression if they’ve watched their loved ones suffer. It is also more cost efficient: Research shows that by providing realistic options and ensuring that care is consistent with what patients and families want, medical centers can reduce useless interventions and save thousands of dollars for every patient cared for by a palliative care service.
Even so, fewer than four in ten California hospitals offer palliative care. In the near future, Pantilat hopes to see many more doctors and nurses trained in palliative care, with better coverage from insurance firms to allow patients to receive both palliative care and disease-focused care at the same time.
For fostering a new approach to caring for patients with life-threatening illnesses and improving their quality of life, Dr. Steven Pantilat is a recipient of a 2011 James Irvine Foundation Leadership Award.
Video by Talking Eyes Media
Dr. Steven Pantilat