Literature Review

Dr. Anne Merriman obituary: doctor known as ‘mother of palliative care in Africa’ The Times, London, England; 6/18/25 Dr. Anne Merriman revolutionised palliative and end-of-life care in Africa after developing a cheap form of oral morphine with a Singapore hospital pharmacist. ... Universally known as “Dr. Anne”, she said: “It’s easier than baking a cake.” She developed the pain-controlling recipe after seeing terminally ill patients discharged from hospital because “nothing more could be done for them”. Many died at home in severe and prolonged pain. “A wild, undisciplined schoolgirl” who became a nun and a doctor, Merriman founded the pioneering Hospice Africa Uganda (HAU) in 1993 at the age of 57. Palliative care was largely unknown in Africa when she started her work in Uganda. HAU has treated more than 35,000 patients and trained more than 10,000 healthcare professionals from 37 African countries in the so-called Merriman model. ... Anne Merriman, doctor, was born on May 13, 1935. She died from respiratory failure on May 18, 2025, aged 90.

Nurse practitioners step in as geriatrician ranks shrink The Washington Post; by Jariel Arvin; 6/15/25 On Fridays, Stephanie Johnson has a busy schedule, driving her navy-blue Jeep from one patient’s home to the next, seeing eight people in all. Pregnant with her second child, she schleps a backpack instead of a traditional black bag to carry a laptop and essential medical supplies ... “Our patient isn’t just the older adult,” Johnson said. “It’s also often the family member or the person helping to manage them.” Johnson isn’t alone. Today, nurse practitioners are increasingly filling a gap that is expected to widen as the senior population explodes and the number of geriatricians declines. The Health Resources and Services Administration projects a 50 percent increas in demand for geriatricians from 2018 to 2030, when the entire baby boom generation will be older than 65. ...

The shrinking physician leadership pipeline Becker's Clinical Leadership; by Mariah Taylor; 6/6/25 Leaders across the nation are noticing a new trend — physicians seem less willing and interested in taking on roles beyond their clinical work. Traditionally, physicians have balanced full-time clinical loads with extra responsibility as a leader or educator. “But as people and the workforce have evolved, there’s a growing understanding: if you’re going to commit to something and do it well, you need dedicated time to focus on it,” Michael White, MD, executive vice president and chief clinical officer at Valleywise Health in Phoenix, told Becker’s. ... The increased interest in work-life balance for medical professionals has also contributed to younger physicians declining extra responsibilities. 

Fostering a team-based approach to elevate neuro-oncology care CancerNetwork; by Sylvia Kurz, MD, PhD; 6/9/25 Sylvia Kurz, MD, PhD, spoke with CancerNetwork® about the importance of collaborating with multiple disciplines to elevate the level of care and meet the needs of patients with brain tumors.

Hospice staff at UVM Home Health and Hospice vote to form union Vermont Biz - Vermont Business Magazine; by Tim, The University of Vermont Health Network - Home Health & Hospice; 6/6/25 After six months of organizing, a majority of the roughly 85 Hospice staff at UVM Home Health and Hospice voted Thursday to formalize their union. Hospice United will represent Nurses, LNAs, Social Workers, Chaplains, Bereavement Coordinators, Volunteers Coordinators, Cooks, and Admin Support in both the McClure Miller Respite House and the community-based team. ... With a 88% voting yes, this victory marks the establishment of union representation at every one of UVM Health Network’s seven locations. Once the votes are certified, staff will begin the process of bargaining their first contract with the UVMHN administration.  

Cleveland Clinic virtual care service expands throughout US Becker's Health IT; by Giles Bruce; 6/4/25 The Clinic by Cleveland Clinic, a virtual second opinion service, is expanding its licensure to thousands of additional providers across the nation. The Clinic partnered with credentialing company Baton Health to grow its provider licenses to more than 10,000, spanning the entire country. The Clinic, a joint venture between Cleveland Clinic and telehealth company Amwell, offers quick access to physicians and subspecialists for virtual second opinions. 

Provider MiraSol Health launches new Behavioral Health Program Hospice News; by Jim Parker; 6/3/25 MiraSol Health has launched a new behavioral health program designed to amplify emotional and psychological support for its hospice and palliative care patients. Branded as Rays of Hope Behavioral Health, the program offers individual and group therapy sessions, both in person and via a secure telehealth platform. Through Rays of Hope, MiraSol’s licensed therapists will help address anticipatory grief, caregiver stress, loss and other struggles that patients and families face during a time of chronic, serious or terminal illness.

Hawai'i Pacific University alumni join forces to build a pioneering palliative care team for student excellence Special to The 'Ohana - HPU's Daily News, Honolulu, HI; 6/3/25 A group of HPU alumni from the nursing, social work, public health and business administration programs ... will be working towards steering a newly established palliative care team at HPU to assist nursing students, social workers and public health students to play an important role in understanding palliative care, hospice and communication with family and survivors. The team will play a role in setting up clinical placements in the community at St. Francis Palliative Care Units and Hospice, to give our nursing students invaluable hands-on experience in providing compassionate care for patients with serious and life-limiting illnesses. HPU Assistant Professor Joy Bliss, Ph.D., will also be designing simulations for “effective listening and communication skills,” to enhance student’s performance and skills in grief and this specialty of nursing. ... This initiative is not only an opportunity to strengthen the clinical training of nursing students, but also an essential step forward in improving the availability and quality of palliative care in Hawaiʻi. 

The importance of humanity in internal medicine I.M. Matters from the American College of Physicians; President's Message by Jason M. Goldman, MD, MACP; June 2025I recently attended the funeral of one of my long-time patients, who had required hospice care after a long battle with heart disease. Many of us have had the experience of telling a patient and their family that their disease has progressed and we have reached the limits of medical science. In training, we are taught to be compassionate but professional, maintaining a certain level of emotional detachment ... As internal medicine specialists, we have the awesome responsibility and privilege to be the doctor for our patients through decades of their life experiences and to offer them not just medical science, but also humanity and comfort. ... One of the greatest acts of charity a person can perform is to attend someone's funeral, as it is the only act of kindness that cannot be reciprocated. This patient had been in my practice for almost two decades, and I had the privilege of taking care of both her and her husband.Editor's note: Re-read this powerful statement, "One of the greatest acts of charity a person can perform is to attend someone's funeral, as it is the only act of kindness that cannot be reciprocated." 

Hospitalists should champion hospice as ‘life with dignity’ Medscape; by Julie Peck; 5/29/25 If anyone can put a positive spin on the end of life, it’s Charles Vialotti, MD, director of Hospice Care at Holy Name Medical Center’s Villa Marie Claire in Bergen County, New Jersey. Violotti, who at the age of 80 lives at the 20-bed Villa Marie Claire to serve its residents full-time, says the hospice industry needs hospitalists’ help with sort of a rebrand, one that will almost certainly have a positive effect on patient and family satisfaction. “Providers used to stress offering people death with dignity. And if you think about that, who is ever going to choose anything that offers death? Death in any form is still death,” Vialotti said. “So, we really like to focus on offering people life with dignity, giving people back choice, giving them the option to structure their final days, weeks, or months the way they would most like to see it happen."

Colorado end-of-life care residency requirement challenged Bloomberg Law; by Ryan Autullo; 5/22/25 A terminally ill Minnesota man is asking a federal court to let doctors in Colorado administer drugs to him so he can die peacefully there, a challenge to the state’s residency requirement in accessing end-of-life care. Prohibiting Colorado doctors from giving non-residents drugs to ease suffering in their final months is unconstitutional, lawyers for Jeff McComas wrote in a complaint filed Thursday in the US District Court for the District of Colorado.

When patients die: A myeloma specialist grieves Medscape; by Manni Mohyuddin, MD; 5/28/25 ... We form such beautiful bonds with patients as we guide them through the highs and lows of treatment. And that is why I struggled so profoundly with the abrupt separation created by a transition of a patient to hospice. How can it be okay for me to be seeing a patient weekly (and sometimes more often) for such a long time and then suddenly never see them again after they transition to hospice? How can we just disappear from their lives at such a critical juncture? I understand that I may not have more chemotherapy to offer, but I at least can offer emotional support, validation, and my friendship. ...Editor's note: Continue reading this powerful commentary. Taking this further, do you have HIPAA compliant systems in place to notify the patient's oncologist or pre-hospice primary physician of the death? 

Primary mental health competencies for hospice and palliative medicine physicians: A Delphi studyJournal of Pain and Symptom Management; by Lisa Podgurski, Danielle Chammas, Keri O Brenner, Leah B Rosenberg, Neha G Goyal, Maria I Lapid, Sue E Morris, William F Pirl, Bridget Sumser, Benjamin W Thompson, Lindsey Wright, and Daniel Shalev; 5/20/25  Objectives: To establish and prioritize 'primary mental health competencies' for specialist hospice and palliative medicine physicians using expert consensus methods. Results: The expert panel proposed 68 competencies divided into: (A) psychological foundations of serious illness care, (B) diagnosis and management of mental health disorders in serious illness, and (C) systems-based practice. After first-round voting, 23 competencies were recirculated for a second vote. Following second-round voting, 32 competencies were included in the final list: 7 from part A, 20 from part B, and 5 from part C.