Jamie H. Von Roenn, MD: Palliative Care in the United States
Dr. Jamie Von Roenn discusses palliative care in the United States. Jamie H. Von Roenn, MD is the Co-Director of the Cancer Control Program at the Robert H. Lurie Cancer Center at Northwestern University in Chicago.
The Group Room at the 2011 American Association For Cancer Research Annual Meeting was made possible, in part, by:
VIDEO TRANSCRIPT:
Selma R. Schimmel, Founder & CEO, Vital Options International:
This is Selma Schimmel at ASCO 2011 where our conversation continues with physicians about a variety of topics. But this one’s very, very special because it’s an area of medicine that we need to talk more about. And it has to do with how we confront later stage of disease, end-of-life issues, palliative care, hospice care – it’s all a part of life. We’re going to spend time with one of the leaders in the United States in this area of medicine, Dr. Jamie Von Roenn. Dr. Roenn is a medical oncologist, treats breast cancer but is also the medical director of Northwestern’s Memorial Hospital’s Home Hospice Programs, Professor of Medicine at Northwestern University, Feinberg School of Medicine, Robert H. Lurie Cancer Center right here in Chicago. Talk to us with your work with hospice and where we are nationally, and is the hospice program – does it vary a lot by region? Or is there, sort of, a national hospice orientation, or is it different by state?
Jamie H. Von Roenn, MD, Co-Director, Cancer Control Program, Lurie Cancer Center:
So I’ve been the medical director of the Hospice at Northwestern since the late ‘80s, hard to believe, and so I’ve watched it grow over time. Most of the hospice in this country is really defined by the Medicare benefit, which has regulations and requirements that make it an inter-disciplinary team that’s available 24-hours a day. That’s inpatient’s home, whether that home is a house or a nursing home, or wherever it may be. There’s variability in what additional services are available, and what the level of resources are for things beyond the Medicare benefit. So some programs, for example, have pet therapy, or music therapy, or massage therapist. Some programs allow people to get radiation. Hospice, in this country, is like a HMO for the end of life. That is, all the meds that are related to end-of-life symptoms are covered, the durable equipment, the ‘person’ services – so nurses, social worker, chaplain, physician, volunteers; all those are covered. So, very small programs tend not to be able to afford things like radiation therapy. We need to change the funding of hospice in this country because really, good palliative care at the end of life sometimes is not so technology-free. Radiation is a very effective way to control bone pain, for example, and it should be a choice for those patients.
Selma R. Schimmel:
A person who is not yet of Medicare age, will most insurance plans cover palliative and hospice care?
Jamie H. Von Roenn:
Yes. Most insurance covers the same benefits as the Medicare benefit across the board. And the truth is, hospice is mandated to take patients regardless of pay. So most programs have some people that pay nothing, and they’re covered.
Selma R. Schimmel:
Closing thoughts?
Jamie H. Von Roenn:
Closing thoughts – The dream I have is that palliative care will be truly integrated into oncology care. And I’ve been wishing for this my whole career but all of a sudden it seems like it’s going to happen. I’m the most optimistic I’ve ever been about the likelihood of this coming to be.
Selma R. Schimmel:
And the advocate community; there’s so many fantastic advocacy organizations – what can they do to help bridge this communication gap?
Jamie H. Von Roenn:
We actually need them to demand this service. We need, in the same way that research for breast cancer exploded when the advocacy groups came alive, we need them to do this for palliative care. They should be demanding symptom control, they should be demanding honest communication about their prognosis. We really need them to be a part of the process.
Selma R. Schimmel:
Thank you, Dr. Jamie Von Roenn; such a privilege to have had this time with you. Congratulations again, recipient of the 2011 ASCO ACS Award and lecture for really pioneering work in palliative medicine and cancer pain management. You’re a medical oncologist, you treat breast cancer but you’re the Medical Director of Northwestern’s Memorial Hospital’s Home Hospice Programs, and Professor of Medicine at Northwestern University’s Feinberg School of Medicine, Robert H. Lurie Cancer Center right here in Chicago.
Dr. Jamie H. Von Roenn:
Thank you for inviting me. It’s been a pleasure.
END OF VIDEO