(HealthDay News) — To deal with the increasing demand for palliative care services, a coordinated palliative care model is proposed, according to a perspective piece published online March 6 in the New England Journal of Medicine.

Noting that the value of palliative care has been recognized and the demand for such care is increasing, Timothy E. Quill, M.D., from the University of Rochester Medical Center in New York, and Amy P. Abernethy, M.D., from the Duke University School of Medicine in Durham, N.C., discuss a coordinated care model which could improve the availability of palliative care.

The authors note that there are barely enough new trainee palliative care specialists to replace retiring physicians, and that increased fellowship funding may go some way to alleviating the problem. In addition, a coordinated care model that distinguishes primary palliative care (skills all physicians should have) from specialist palliative care (skills for managing complex and difficult cases) should be introduced. Each medical specialty should delineate basic expectations regarding primary palliative care skills and a triage system for receiving specialist palliative care, as necessary. All medical students and residents should be trained in basic palliative care skills. This model could simplify the health care system, enhancing the skills of primary care physicians and reducing the number of specialists involved in routine cases, but is unlikely to undermine specialty palliative medicine.

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“We hope that every medical field will define a set of basic palliative skills for which they will be primarily responsible and distinguish from palliative care challenges requiring formal consultation,” the authors write.

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