11-26-12: The Need to Discuss Palliative Care

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Palliative-1126.mp3

Throughout the debate that resulted in the passage of the Affordable Care Act, or Obamacare, policy makers, economists, and medical ethicists all pointed to the fact that so much of our health care dollars are spent near the end of people’s lives.  For example, about 25% of Medicare dollars are spent in the last year of life.  But end-of-life issues are not just economic issues, of course.  When physicians and their patients are confronted with an incurable disease, how do both parties grapple with that challenge?  

Dr. Thomas J. Smith is an oncologist and the Director of Palliative Medicine at Johns Hopkins Sydney Kimmel Comprehensive Cancer Center.  Last month, he published an essay in the New England Journal of Medicine about how doctors should talk to patients about dying. 

Here, Dr. Smith talks about Tom about palliative care.  In the interview, Tom mentions his series of conversations with the writer Dudley Clendinen, and his journey with ALS.  Dudley was very open about his disease.  You can listen to those conversations here.

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Thomas Smith on medical school .mp3

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Tom Smith on differences between palliative care and hospice.mp3