In 2006, ''hospice and palliative medicine'' was officially recognized by the

American Board of Medical Specialties Established in 1933, the American Board of Medical Specialties (ABMS) is a non-profit organization which represent 24 broad areas of specialty medicine. ABMS is the largest physician-led specialty certification organization in the United States ...

, and is ''co-sponsored'' by the American Boards of * Internal Medicine *

Anesthesiology Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, ...

Family Medicine Family medicine is a medical specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who is usually a primar ...

Physical Medicine and Rehabilitation Physical medicine and rehabilitation, also known as physiatry, is a branch of medicine that aims to enhance and restore functional ability and quality of life to people with physical impairments or disabilities. This can include conditions s ...

Psychiatry Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psychiatry. Initial p ...

and

Neurology Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal ...

Surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pa ...

Pediatrics Pediatrics ( also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until the ...

Emergency Medicine Emergency medicine is the Medical specialty, medical speciality concerned with the care of illnesses or Injury, injuries requiring immediate medical attention. Emergency physicians (often called “ER doctors” in the United States) continuous ...

Radiology Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiat ...

Obstetrics and Gynecology Obstetrics and Gynaecology (also spelled as Obstetrics and Gynecology; abbreviated as Obs and Gynae, O&G, OB-GYN and OB/GYN) is the medical specialty that encompasses the two subspecialties of obstetrics (covering pregnancy, childbirth, and ...

Physicians who complete a residency in one of the ''co-sponsoring'' specialties are then eligible for further training in an

ACGME The Accreditation Council for Graduate Medical Education (ACGME) is the body responsible for accrediting all graduate medical training programs (i.e., internships, residencies, and fellowships, a.k.a. subspecialty programs) for physicians in the ...

-approved Hospice and Palliative Medicine fellowship program, after which they must pass the official examination to be board-certified in the subspecialty. In 2007, the

American Osteopathic Association Bureau of Osteopathic Specialists Established in 1939, the American Osteopathic Association Bureau of Osteopathic Specialists (AOABOS) is a non-profit umbrella organization for 18 medical specialty boards in the United States. Along with the American Board of Medical Specialties (A ...

approved a Certificate of Added Qualifications (CAQ) in ''hospice and palliative medicine''. By 2012 participants are the American Osteopathic Boards of * Internal Medicine *

* Neurology and Psychiatry *

. Candidates are eligible for CAQ certification after achieving board-certification following an

American Osteopathic Association The American Osteopathic Association (AOA) is the representative member organization for the more than 176,000 osteopathic medical doctors (D.O.s) and osteopathic medical students in the United States. The AOA is headquartered in Chicago, Illinoi ...

-approved

residency Residency may refer to: * Domicile (law), the act of establishing or maintaining a residence in a given place ** Permanent residency, indefinite residence within a country despite not having citizenship * Residency (medicine), a stage of postgrad ...

Etymology and historical development

Hospice comes from the Latin word hospitum which means hospitality. Initially as a form of lodging for the sick, hospice refers to holistic end of life care. The word palliate comes from the Latin word "pallium", which means "cloak"—to palliate is to cloak, or cover up, the symptoms of an illness without curing it. Palliative care got its start as hospice care delivered largely by caregivers at religious institutions. The first formal hospice was founded in 1948 by the British physician Dame Cicely Saunders in order to care for patients with terminal illnesses. She defined key physical, emotional, social, and spiritual dimensions of distress in her work. She also developed the first hospice care as well in the US in 1974 - Connecticut Hospice. The National Hospice Organization (NHO) was established in 1978. By 1982, the US government began funding their work via the Medicare Hospice Benefit. In the United States, the Institute of medicine published a report, "Approaching Death: improving care at the end of life" (M.I. Field, and C.K. Kassel) in 1997. This described vast deficiencies in end-of-life care, which prompted support from the Robert Wood Johnson Foundation and the George Soros' Open Society Institute for faculty scholars in this area and a NIH State of the Science conferences. In 2004, Clinical practice guidelines for Quality Palliative Care were released, which expanded palliative care's role beyond dying patients to those with life-limiting illness. By 2006, the American Board of Medical Specialties and the Accreditation Council for Graduate Medical Education recognized the subspecialty of Hospice and Palliative Medicine, and by 2008, there were over 3000 members of the American Academy of Hospice and Palliative Medicine. Today, the field uses interdisciplinary treatment aiming to maintain quality of life while balancing appropriate therapies.

Role of hospice and palliative care physicians

Physicians in this subspecialty have advanced knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting, life-threatening and terminal illnesses. This specialist has expertise in the assessment of patients with advanced disease and

catastrophic injury Catastrophe or catastrophic comes from the Greek κατά (''kata'') = down; στροφή (''strophē'') = turning ( el, καταστροφή). It may refer to: A general or specific event * Disaster, a devastating event * The Asia Minor Catastro ...

, the relief of distressing symptoms, the coordination of interdisciplinary patient and family-centered care in diverse settings, the use of specialized care systems including hospice, the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. They work with an interdisciplinary

hospice Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life b ...

palliative care Palliative care (derived from the Latin root , or 'to cloak') is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Wit ...

team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patients and family members throughout the course of the disease, including through the dying process and subsequent bereavement. This care can occur within or outside of a formal hospice or palliative care team.

Education and training of hospice and palliative care physicians

Physicians must graduate from an accredited medical school. Medical schools may be accredited by either the liaison committee on medical education (LCME) or the American Osteopathic Associations Commission on Osteopathic College Accreditation (AOACOC). Medical school is generally 4 years of training. After completion of medical school, individuals must complete a residency accredited by either the American Committee on Graduate Medical Education (ACGME) or the American Osteopathic Association (AOA) in any number of specialties. Some main specialties include: * anesthesiology * emergency medicine * family medicine * internal medicine * obstetrics and gynecology * pediatrics * physical medicine and rehabilitation * psychiatry and neurology * surgery * radiology After completion of residency, which can generally last from 3 to 7 years, individuals must complete at least 12 months of fellowship in Hospice and Palliative medicine in order to sit for board certification examinations (see below). As of 2021, there are 156 recognized fellowship programs in Hospice and Palliative Medicine.

Certification of specialists

The American Academy of Hospice and Palliative Medicine (AAHPM) is the leading professional organization for physicians subspecializing in hospice and palliative medicine in North America. The International Association for Hospice and Palliative Care is the major professional organization devoted to the global spread of hospice and palliative medicine. The American Board of Internal Medicine administers the initial board certification exam for allopathic physicians seeking certification in hospice and palliative medicine. Exams are offered during the fall of even numbered years. The American Osteopathic Association administers the initial board certification exam for osteopathic physicians seeking certification in hospice and palliative medicine. Physicians have the option of 5 Boards to obtain the Certificate of Added Qualification (CAQ) for the specialty. Exams are offered every year.

References

External links