PODCAST

The Surgical Palliative Care Podcast

Surgical Palliative Care

The Surgical Palliative Care Podcast features interviews with the founders and the leaders of the surgical palliative care community, a diverse group of surgeons, dedicated to providing high quality palliative medicine to all surgical and trauma patients. Tune in to learn the rich history of the surgical palliative care movement as well as to stay up to date on the latest research in the field. Hosted by Dr. Red Hoffman, the Surgical Palliative Care Podcast aims to educate, foster community and provide mentorship to all those interested in making certain that surgical and trauma patients receive the excellent palliative care that they deserve. Subscribe to stay up to date on the latest episodes.

Andy Baxter: Founder of Cuniff-Dixon Foundation
Oct 4 2021
48 mins
Dr. Jody Stern: Grief Connects UsDr. Balfour Mount:  Ten Thousand CrossroadsIntroducing The Surgical Palliative Care Society (SPCS)Dr. Pat Murphy: Surgical Palliative Care Nurse Researcher
#024 - Join host Dr. Red Hoffman as she interviews Dr. Patricia Murphy.   Pat is a nurse and is recently retired as the Clinical Clinical Ethicist at University Hospital in Newark, New Jersey. She is an associate professor in the Rutgers-New Jersey Medical School Department of Surgery and served as a member of the New Jersey Bioethics Commission, the multidisciplinary body that developed the Advance Directive and Brain Death legislation in New Jersey.  She is responsible for teacher generations of medical students, residents and attendings how to care for patients and families during the most difficult times of their lives.   In this episode, Pat shares how her time with Dr. Elizabeth Kubler Ross as well as her time in the Faculty Scholars Program of the Project on Death in American shaped her career in palliative care.  She discusses her decades of work in the Department of Surgery at Rutgers NJ Medical School, where she worked closely with Dr. Anne Mosenthal to study the integration of palliative medicine into the care of trauma patients.   Pat gives tips on how to deliver bad news and how best to code status and goals of care with patients and families.   Lastly, she discusses the importance of communication amongst team members and reminds us to listen to our nurses!To read more about the work of Pat Murphy and Anne Mosenthal click here. To hear the story about how Pat influenced the career of Dr. Jessica Zitter watch here. To learn more about the surgical palliative care community, visit us on twitter @surgpallcareTo learn more about host Red Hoffman, visit her website www.redhoffmanmd.com.
Apr 5 2021
39 mins
Dr. Mary Lynn McPherson:  Palliative Care Pharmacist Extraordinaire
#023 - Join host Dr. Red Hoffman as she interviews pharmacist Dr. Mary Lynn McPherson, Professor and Executive Director of the Advanced Post-Graduate Education in Palliative Care in the Department of Pharmacy Practice and Science at the University of Maryland,  Program Director of the Online Master of Science and Graduate Certificates in Palliative Care (also at University of Maryland), host of the Palliative Care Chat Podcast and author of the very well-known book  Demystifying Opioid Conversion Calculations: A Guide for Effective Dosing.  Lynn is a well-known speaker and a respected educator and was named as a 2018 Visionary in Hospice and Palliative Medicine by the American Academy of Hospice and Palliative Medicine.   Lynn discusses the role of the pharmacist on the interdisciplinary palliative care team, including the very important role of de-prescribing medications.  She then offers a step-wise approach to the treatment of common symptoms such as nausea, constipation (spoiler alert- we are using way too much zofran and docusate!), delirium and pain.  Lastly, she answers some of Red's burning questions about tylenol, toradol, transdermal delivery systems and buprenorphine.  Lynn is consistently one of the most most sought-after speakers at the AAHPM Annual Assembly and it is incredible to have the opportunity to learn from her!  To find a copy of Demystifying Opioid Conversion Calculations click here.To listen to the Palliative Care Chat Podcast click here.To learn more about the University of Maryland Online Master of Science and Graduate Certificates in Palliative Care click here. To learn more about the surgical palliative care community, visit us on twitter @surgpallcareTo learn more about host Red Hoffman, visit her website www.redhoffmanmd.com.
Mar 22 2021
45 mins
Dr. Dan Hinshaw:  Spirituality and Surgical Palliative CareDr. Rebecca Aslakson:  Palliative Care in the Perioperative Setting
#021 - Join host Dr. Red Hoffman as she interviews Dr. Rebecca Aslakson, an anesthesiologist - triple-board certified in anesthesiology, critical care medicine and hospice and palliative medicine - and a well known researcher who has devoted her career to improving the delivery of effective and equitable palliative care, particularly to perioperative and critically ill populations.   Rebecca is an Associate Professor at Stanford University with appointments in both the Department of Primary Care & Population Health in the Palliative Care Section and the Department of Anesthesiology, Perioperative and Pain Medicine where she serves as Division Chief of Critical Care Anesthesia. Rebecca discusses how her early work in HIV paved the way for her career as both a researcher and as a palliative care physician.  She shares the story of David, one of her very first patients, who inspired her interest in palliative medicine.   She talks about the importance of honoring the emotive (rather than the cognitive) experiences of our patients as well as the importance of creating a space for patients and families to discuss their spiritual/religious beliefs, whatever they may be.For young physicians, Rebecca's career illustrates the importance of mentorship throughout one's career (and proves that you do NOT have to be mentored by people in your own field).  She also reflects upon the importance of knowing the culture of your medical community and being mindful of that culture when trying to conduct research or introducing an intervention. Beyond being a brilliant researcher, Rebecca is one of the most authentic and heart-centered human beings.  Get ready for both your emotive and cognitive sides to be inspired!Read more about Rebecca, including links to her publications, here.Read more about anesthesia and palliative medicine in the ASA Monitor here.   Read more about the Multicenter, Randomized Controlled Trial of Perioperative Palliative Care Surrounding Cancer Surgery for Patients and Their Family Members (PERIOP-PC) here.To learn more about the surgical palliative care community, visit us on twitter @surgpallcareTo learn more about host Red Hoffman, visit her website www.redhoffmanmd.com.
Nov 16 2020
48 mins
Dr. Preeti John:  Surgical Palliative Care at the VA
Oct 19 2020
35 mins
Dr. Janet Bull:  From Birth to DeathDr. Nancy Glass:  Palliative Care, Pediatrics and AnesthesiaDr. Geoff Dunn:  The Father of Surgical Palliative Care
#017 - Join host Dr. Red Hoffman and cohost Dr. Pringl Miller as they interview Dr. Geoff Dunn, the father of the Surgical Palliative Care Movement.  Geoff is a fourth generation surgeon, a second generation hospice medical director (his father was also both a surgeon and a hospice medical director!) and an artist.   Along with Dr. Bob Milch, Geoff is responsible for starting the integration of the concept of palliative medicine into the work of the American College of Surgeons (ACS), the largest surgical organization in the country.   As he shares in this episode, at the ACS Clinical Congress in 1997, he was invited by Dr. Tom Krizek to address a large gathering of surgeons during a symposium focused on physician-assisted suicide.  As he approached the microphone, Tom whispered to him, "You have ten minutes to change surgery... Don't mess it up!"  Geoff took this to heart and over the next two decades he worked tirelessly to integrate palliative medicine into surgical practice through chairing the  ACS Committee on Surgical Palliative Care, writing countless articles, editing  numerous books, speaking at numerous conferences, and - perhaps most importantly - never preaching!   As a lover of history, Geoff has tirelessly documented the history of the Surgical Palliative Care movement, most recently in a chapter of the Surgical Palliative Care textbook (link below).  As a lover of art and literature, Geoff has often utilized in his quest to better explain palliative medicine to surgeons, most memorably by comparing the Family Conference to a surgical procedure in which we "Prepare, Do and Close."  Despite all of his achievements, Geoff remains humble, heart-centered and human.  Listen and enjoy learning the history of the Surgical Palliative Care Movement!To read more by Geoff Dunn:Surgical Palliative Care-  Along with Anne Mosenthal, Geoff served as co-editor and also authored a chapter highlighting how surgeons have been involved in palliation since the beginning of the profession.  Surgical Clinics of North America- Geoff edited the 2011 edition focused on Surgical Palliative Care.  The 2019 edition, edited by Pringl Miller, can be found here.  Surgical Palliative Care:  A Resident's Guide- Geoff served as one of the co-editors of this extremely useful (and free) guide to providing palliative care to surgical patients.  In this article, Geoff discusses the history of surgical palliative care and the American College of Surgeons.To learn more about the surgical palliative care community, visit us on twitter @surgpallcare.
Aug 24 2020
42 mins
Dr. Rick Greene:  Integrating Palliative Care into Surgical Oncology
#016 - Join host Dr. Red Hoffman as she interviews Dr. Rick Greene, a surgical oncologist and a champion of palliative care for surgical oncology patients.  Rick currently serves as the medical director of the Cancer Data Registry at the Levine Cancer Institute in North Carolina.  As a past president (and founding member) of SAGES, past president of the Southeastern Surgical Society, past chair of the American College of Surgeons Commission on Cancer, past chair of the American Joint Committee on Cancer and past Chair of Surgery at Carolinas Medical Center, Rick can certainly be described as accomplished.  However, what is perhaps even more striking about Rick is how thoughtful and insightful he is, about both medicine and life.  In this episode, he shares his early experiences as a young surgeon aboard the USS Nimitz and discusses the influence of beshart (a Yiddish word which means inevitable or preordained) in his life.  Rick also offers his advice on how best to approach and talk about surgical complications.   Lastly, he discusses how important it is for surgeons to plan for life after surgery and recounts the necessity of always reinventing oneself (Rick is a writer and a radio host!) Articles discussed in the episode:Patient Loss: Surgeons Describe How They CopeThe Joys of Creative WritingCheck out The Recovery Room, a podcast hosted by Dr. Greene and supported by the American College of Surgeons here.To learn more about the surgical palliative care community, visit us on twitter @surgpallcare.
Aug 10 2020
39 mins
Dr. Anne Mosenthal:  The Mother of Surgical Palliative Care
#015 - Join host Dr. Red Hoffman as she interviews Dr. Anne Mosenthal, a trauma surgeon and one of the founding members of the American College of Surgeon's Surgical Palliative Care Task Force (now the Committee on Surgical Palliative Care, which she currently chairs).  Her name is synonymous with surgical palliative care in this country.  Anne, along with nurse Pat Murphy, wrote some of the earliest papers about how to incorporate  palliative care into the surgical and trauma intensive care units.   She championed the integrative model of palliative care, which relies upon the surgical team to utilize their primary palliative care skills.   She is the co-editor (along with Dr. Geoffrey Dunn) of the recently released textbook entitled Surgical Palliative.  Anne served as the Chair of Surgery at Rutgers New Jersey Medical Center for nine years (one of the first women in the country to chair a department of surgery) and recently transitioned into a new role as the Chief Academic Officer of Lahey Hospital and Medical Center.  In this episode, she shares her experience as a woman pursuing a career in surgery and notes the lack of female role models during her training.  She has been a champion for women in surgery, serving as a mentor to many and eventually winning the Association of Women Surgeon's Olga Jonasson Distinguished Member Award in 2018.   She also shares some tips about how to break bad news and how to discuss code status.  Lastly, she very graciously accepts all of my fan-girling!  As I tell her, many of us would not have the careers that we do if it were not for her leading the way.  Listen and learn from one of the very best!Articles mentioned:Trauma Care and Palliative Care: Time to Integrate the Two? (2003)Interdisciplinary model for palliative care in the trauma and surgical intensive care unit: Robert Wood Johnson Foundation Demonstration Project for Improving Palliative Care in the Intensive Care Unit (2006)Integrating palliative care in the surgical and trauma intensive care unit: a report from the Improving Palliative Care in the Intensive Care Unit (IPAL-ICU) Project Advisory Board and the Center to Advance Palliative Care (2012)To read more about or purchase the recently released Surgical Palliative Care (a must have!), click here.To learn more about the surgical palliative care community, visit us on twitter @surgpallcare
Jul 27 2020
36 mins
Palliative Care in the Emergency Department
#014 - Join host Dr. Red Hoffman as she interviews Drs. Kate Aberger and David Wang, emergency medicine physicians who specialize in palliative care.  They are the editors of the recently released book, "Palliative Skills for Frontline Physicians," a collection of case-based vignettes which illustrate how to practically integrate palliative care into all fields of medicine, including surgery, emergency medicine, internal medicine and critical care, among others.  David and Kate discuss how to successfully integrate palliative medicine into the care of emergency room patients, the forces that make this integration difficult and the reality that this work cannot be done without the support of hospital administration.  Kate talks about her palliative care work during the COVID epidemic in New Jersey and David shares research conducted at his institution which showed that palliative care consults placed by ED physicians at admission resulted in decreased length of stay and lower overall hospital costs for patients.   Join us for another inspiring episode that proves that palliative medicine can be utilized successfully throughout the hospital, even in the basement (where it seems many EDs are located!). To learn more about the recently released Palliative Skills for Frontline Physicians, click here. To learn more about palliative care in the emergency department read this article by Dr. Wang.  To learn more about the surgical palliative care community, visit us on twitter @surgpallcare.
Jul 6 2020
45 mins
Dr. Gretchen Schwarze: Surgical Buy-In and Best Case/Worst Case
#013 - Join host Dr. Red Hoffman as she interviews Dr. Gretchen Schwarze, a vascular surgeon, medical ethicist and prolific researcher known for her work focused on surgical buy-in and the best case/worst case scenario.  Gretchen is an endowed professor in the Division of Vascular Surgery, Department of Surgery, at the University of Wisconsin School of Medicine and Public Health.  She completed a fellowship in medical ethics at the MacLean Center for Medical Ethics.  She is a nationally recognized expert in surgical decision making, informed consent, advance directives and end-of-life care and her research focuses on improving communication between older patients and their surgeons so that patients can avoid unwanted treatment and make decisions that align with their values, preferences and goals.  Gretchen defines the concept of surgical buy-in and explores how this concept manifests differently for various patients and various procedures.  We discuss the ethics surrounding Do Not Resuscitate orders in the OR and the importance of clearly establishing the goals of surgery (prolonging life, improving quality of life, making a diagnosis or preventing a disability) before operating.  Finally, Gretchen explains the Best Case/Worst Case decision aid and notes the importance of both eliciting preferences and making recommendations when using this aid.  I learned so much from speaking with Gretchen; she helped me to articulate many of the ethical dilemmas I struggle with when taking care of many of my surgical patients. Articles mentioned:Surgeons Expect Patients to Buy-In to Postoperative Life Support Preoperatively A Framework to Improve Surgeon Communication in High-Stakes Surgical Decisions: Best Case/Worst Case"Best Case/Worst Case": A Qualitative Evaluation of a Novel Communication Tool for Difficult in-the-Moment Surgical DecisionsRisk Calculators and Decision Aids are Not Enough for Shared Decision MakingTo learn how to do Best Case/Worst Case, watch a ten minute video here.  To learn more about the Maclean Center Fellowship in Medical Ethics, click here.To learn more about the surgical palliative care community, visit us on twitter @surgpallcare
Jun 22 2020
51 mins
Dr. Jack M. Zimmerman: The Reluctant PioneerSurgical Ethics: Do Not Resuscitate (DNR) orders in the OR
#011 - Join host Dr. Red Hoffman as she speaks with surgeons Drs. Sara Scarlet, Pringl Miller and Kim Kopecky about surgical ethics, particularly those surrounding Do Not Resuscitate Orders in the operating room.   All three completed a fellowship in medical ethics and Drs. Miller and Kopecky are also fellowship-trained in Hospice and Palliative Medicine.  Dr. Scarlet served as the co-editor of the April 2020 issue of the AMA Journal of Ethics which focused on the relationship between surgeons and anesthesiologists.  Together, we review the basic principles of medial ethics, discuss why we seem to focus so much on autonomy and reflect upon how training in both ethics and palliative medicine have affected how we practice as surgeons.  We talk about some of the common challenges which exist within the surgeon-anesthesiologist relationship and ways in which we can better navigate our differences.  Finally, we review what the various societies have to say about upholding DNR orders in the OR (spoiler alert:  there are NO policies which insist that patients rescind their DNR orders before going to the OR) and talk about some tips and tricks that work when having these sometimes difficult and nuanced conversations.    To learn more about the Maclean Center Fellowship in Medical Ethics, click here.To read the AMA Journal of Ethics:  April 2020 Anesthesiologist-Surgeon Relationships, click here.Statements on DNR in the OR:American College of SurgeonsAmerican Association of AnesthesiologistsAssociation of Perioperative Nurses To learn more about the surgical palliative care community, visit us on twitter @surgpallcare
May 18 2020
44 mins
Special Edition: Joint Episode with the GeriPal Podcast!Dr. Ira Byock: National Leader in Palliative Care
#009 - Join host Dr. Red Hoffman as she interviews Dr. Ira Byock, nationally known author and speaker and the founder and chief medical officer of the Institute for Human Caring at Providence St. Joseph in Southern California.  Ira served as the president of the American Association of Hospice and Palliative Medicine as well as the Director of the Robert Wood Johnson Foundation's Promoting Excellence in End of Life Care, under which the Surgeons Palliative Care task force (now the Committee on Surgical Palliative Care) was created within the American College of Surgeons.  For those interested in the history of surgical palliative care, Ira is also known as the man who introduced surgeons Dr. Robert Milch to Dr. Geoffrey Dunn (both men went on to become leaders in the field of surgical palliative care).  Ira shares that seeing how poorly patients at the end of life were treated in his training hospital led him to develop a hospice program while still a resident physician.  He discusses that illness is fundamentally a personal issue (rather than a medical issue) and that by acknowledging this, surgeons can do their part in making certain that patients get the best care possible.  He is thoughtful, inspiring, generous with both his time and his experience, and a pure joy to talk to!Learn more about Ira here.Ira's books include:The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life Dying Well: Peace and Possibilities at the End of LifeThe Four Things that Matter MostLearn more about the Surgeons Palliative Care Workgroup here (includes PDFs of over two dozen articles written about surgical palliative care and published in the Journal of the American College of Surgeons.)To learn more about the surgical palliative care community, visit us on twitter @surgpallcare
May 4 2020
48 mins