Literature Review

Why palliative care is more than just end-of-life support MedPageToday's KevinMD.com; by Dr. Vishal Parackal; 9/1/25 ... Palliative care as a system requires strong interpersonal and cross-specialty communication for smooth functioning, as patients may require expert opinions from different fields to optimize their treatment plan. Patient education for systemic follow-ups and establishing a baseline of knowledge regarding their diagnosis and potential danger signs helps create a better environment for holistic care. While we focus on the physical aspects of care and diagnosis, we often fail to realize the psychological and mental impact that such conditions can have on the patient and their family. ... The opportunity to make a meaningful difference in patients’ lives by easing their suffering and enhancing their quality of life is profoundly fulfilling. ... Editor's Note: Excellent descriptions of palliative care.

What do physicians want at the end? An international qualitative study on physicians’ personal end-of-life preferences and what influences them Palliative Care and Social Practice; by Sarah Mroz, Frederick Daenen, Sigrid Dierickx, Freddy Mortier, Ludovica De Panfilis, Luca Ghirotto, Toby Campbell, Kenneth Chambaere, and Luc Deliens; 7/4/25 Research Results: ... Most physicians prefer to avoid aggressive and life-prolonging treatment, physical and mental suffering, and being a burden. They prioritize being in a peaceful environment and communication with loved ones. Various factors influence preferences including cultural, social, and religious beliefs, and legislative environment, but most significant are the deaths of loved ones and clinical practice. Death and dying become normalized the more they are reflected upon and discussed, and this process can also provide personal growth which helps physicians provide better care to patients and families.

More time, less paperwork: The quiet revolution in primary careModern Healthcare; by Alex Kacik; 8/26/25Concierge and direct primary care practices are gaining traction among physicians, employers and patients increasingly frustrated with traditional care pathways. The growth of these practices, where patients pay membership fees in exchange for increased access to physicians, is a symptom of Medicare and Medicaid reimbursement that has not kept pace with inflation, advisers, doctors and policy experts said. Growing care backlogs, coding and documentation tasks that take doctors away from patients and seemingly ever-rising health insurance premiums are also contributing, they said. “A year ago, I would’ve told you these care models were a slowly evolving, quiet phenomenon,” said Dr. Zirui Song, an associate professor of healthcare policy at Harvard Medical School and a primary care provider at Massachusetts General Hospital. “It is now evolving quite rapidly — it is not so quiet anymore.”Publisher's note: Is concierge medicine coming to a hospice or palliative care provider near you...?

RN median hourly pay, by stateBecker's Hospital Review; by Kelly Gooch; 8/19/25Median hourly base pay for registered nurses varies across states, with RNs in California earning the most, according to SullivanCotter’s “2025 Health Care Staff Compensation Survey Report.” The survey, released in July, covers nearly 2.5 million healthcare employees across over 2,660 participating organizations, including more than 800,000 individual RNs, licensed practical nurses and nursing managers. Here is the median per-hour base pay for RNs, by state, according to survey data shared with Becker’s [see article for all states]:

Why more doctors can't make ends meetAxios; by Tina Reed; 8/12/25America's doctors are working harder and getting paid less. And that could soon translate into less access for some patients. The big picture: A new report from consultancy Kaufman Hall shows primary care physicians and specialists are delivering more services since the pandemic. But they're not making more money because of stagnant reimbursements from public and private insurers and inflation. The data helps explain why medical practice bankruptcies hit a six-year high last year — and why some providers are shifting to pricey procedures for cash-paying customers to boost their bottom lines.

Hands Journal of the American Medical Association (JAMA); by R. Jordan Williams, MD, MPH; 8/13/25Lend me your hand Callused or calaminedWrinkled or plump,Nails bittenNails extendedSplintered and pittedNails neatly or never cropped.Lend me your hand Strong or weak Cold or warmingSwollen and swanned; Gnarled in knots ...Editor's Note: Continue reading this powerful poem. Additionally, JAMA published this description of the poem, "Poetry and the Medicine of Touch" by Rafael Campo, MD, MA: "In this deeply felt poem, the hand becomes a potent metaphor for our shared humanity ... Aspiring clinicians are still taught to assess, to palpate, to diagnose through touch. Yet, as “Hands” reminds us, patients’ hands hold far more than clinical signs—they reflect stories, histories, fears, and hopes. ..."

Guest Voice: What ‘It’s a Wonderful Life’ teaches us about living with MS Multiple Sclerosis News Today; by Donald Kushner, MD; 8/15/25 Donald Kushner, MD, is a retired physician, board certified in internal medicine and hospice and palliative care. He has been living with multiple sclerosis (MS) for more than 20 years and draws on his dual perspective as both doctor and patient to explore illness, identity, and adaptation. He’s writing a book about how people with chronic illness and their support systems can better understand — and talk to — each other.

Integrating advance care planning into end-of-life education: Nursing students’ reflections on advance health care directive and Five Wishes assignmentsNursing Reports; by Therese Doan, Sumiyo Brennan; 7/25Advance care planning tools, such as the Advance Health Care Directive (AHCD) and Five Wishes, provide experiential learning opportunities [for prelicensure nursing students] that bridge theoretical knowledge with real-world patient advocacy. In this study, students were asked to complete either the AHCD or Five Wishes document as though planning for their own end-of-life care, encouraging personal reflection and professional insight. Students developed critical insights into their personal values, envisioned themselves in EOL scenarios, and reflected on their responsibility as future nurses. The assignment fostered both professional development and personal growth, making it a meaningful experience within the nursing curriculum. By encouraging students to engage personally with end-of-life decisions, the assignment cultivates empathy, ethical reflection, and a readiness to initiate sensitive conversations.

This test tells you more about your heart attack risk KFF Health News; by Paula Span; 8/1/25 A long list of Lynda Hollander’s paternal relatives had heart disease, and several had undergone major surgeries. ... A cardiologist told Hollander that based on factors like age, sex, cholesterol, and blood pressure, she faced a moderate risk of a major cardiac event, like a heart attack, within the next 10 years. ... Her doctor explained that a coronary artery calcium test, ... could provide a more precise estimate of her risk of atherosclerotic heart disease. “The test is used by more people every year,” said Michael Blaha, co-director of the preventive cardiology program at Johns Hopkins University. Calcium scans quadrupled from 2006 to 2017, his research team reported, and Google searches for related terms have risen even more sharply. Yet “it’s still being underused compared to its value,” he said. One reason is that although the test is comparatively inexpensive ...Editor's Note: Good news. This test predicts and protects heart health, potentially providing extra years of good (or at least better) quality of life. Bad news. It is "being underused compared to its value," partly because "the test is comparatively inexpensive"? Bad news. What does the low-cost factor say ethics, choices, and quality of life? Good news. Because of my family's cardiac history, my physician recently recommended I take this test. I did, and received great results! I move into the future with greater confidence, less fear, and more gratitude for the some 100,00 heartbeats we each experience, each day.

Demographic variations and temporal trends in hospice and palliative care fellowship matches in the United States Scientific Reports; by Aman Goyal, Samuel L. Flesner, Urooj Shamim, Sonia Hurjkaliani, Priya Goyal, Mohamed Daoud & Amir Humza Sohail; 8/8/25 ... In summary, the number of Hospice and Palliative Care fellowship training programs, positions, and applicants increased. Female applicants, compared to males, and White applicants, relative to their representation in all fellowships, accounted for a larger proportion of applications and had higher match rates. ... Future research should focus on initiatives to address challenges such as the underrepresentation of certain demographics in palliative care and the growing demand for trained professionals as the population ages. 

New report gives healthcare providers fresh guidance on communicating with older adults McKnights Long-Term Care News; by Donna Shryer; 8/7/25 A new report from the Gerontological Society of America reveals critical strategies for healthcare providers to improve communication with older adults, who now represent almost 17% of the US population. The comprehensive guide, titled “Communicating With Older Adults: A Review of What Really Works,” addresses the growing need for effective patient-provider interactions as America ages. Approximately one-third of adults aged 65 or more years have a disability that may affect communication, the report noted. 

Sovereign Hospice highlights nutrition's role in hospice home care services News Channel Nebraska (NCN), reprinted from Aubrey, TX; Press Release; 8/8/25 Eating becomes more than a necessity during serious illness—it becomes a part of daily care that supports comfort, strength, and emotional connection. At Sovereign Hospice in Aubrey, Texas, nutrition is integrated into the services hospice offers, especially for patients receiving hospice at home services. The goal is to use food as a gentle tool to improve quality of life. Serious illnesses can change how patients eat. Appetite loss, difficulty swallowing, and taste changes are common, but they can be managed through small adjustments.