Introducing Palliative Care to Patients

Introducing palliative care to patients poses a challenge. It’s a service that is unfamiliar or misunderstood by many patients and their families, so first impressions can make a difference on the relationship you develop with the patient and their family. I struggle to find an introduction that is simple, relatable, and genuine. If you come in with too narrow a focus, it can seem as though you have an agenda or know something the patient doesn’t:

“Hi, I’m Dr. Sable-Smith from the palliative care team and I’d like to talk about your preferences for the end of life.”

On the other end of the spectrum, we’re also prone to confuse people with ambiguous platitudes like “we’re just and extra layer of support.”

After trying out introductions along the spectrum, I found one that feels right. I learned it from two two of my mentors at Stanford. It goes something like this:

“Hi, I’m Dr. Sable-Smith with the palliative care team. Our specialty is quality of life for people living with serious illness. We commonly help people in three different areas. One is physical symptoms like pain or nausea. Two is the emotional aspect of being sick for you and your family. Three is that we can help guide you through tough conversations that other people may not want to have. Does any of that sound helpful to you right now?”

This introduction works well for me when the patient is relatively low-acuity and when the consult is sort of ambiguous (i.e. “can you help with symptoms and support? This patient is really struggling with their diagnosis”). It works very well in the outpatient setting as well.

Of course, sometimes I am consulted for a high-acuity, very specific need like an extubation where this introduction is not appropriate and a narrow focus is necessary.