PAs in Hospice and Palliative Care

Introduction and Directions

Physician Assistants have not been included in many national "core" documents and policy making conversations regarding Palliative Medicine, notably:

1) The recent report "Dying in America" from the Institute of Medicine does not mention PAs, though it specifically mentions doctors, nurses, social workers and chaplains as care providers.
2) The Joint Commission standards on Advanced Certification for hospitals for Palliative Care do not mention PAs when it refers to core staff, while doctors and nurse practitioners are mentioned, thus potentially limiting our participation.

3) Hospice Congressional bills that outline reimbursed services for Medicare and Medicaid do not include PAs.

PAs need to be incorporated into palliative care practice. Our survival may depend on integrating into these documents, in order to continue to provide services to our patients on these teams. Please help us to retrieve valuable data using this survey to assist in getting recognition that is needed to move forward. Thanks for your support!

Question Title

* 1. Please indicate how often you do the following in your clinical practice:

	Daily	A few times a week	A few times a month	A few times a year	Never/hardly ever
Talk with patients and families about their goals of care	Talk with patients and families about their goals of care Daily	Talk with patients and families about their goals of care A few times a week	Talk with patients and families about their goals of care A few times a month	Talk with patients and families about their goals of care A few times a year	Talk with patients and families about their goals of care Never/hardly ever
Talk with your patients about advance care planning and advance directives	Talk with your patients about advance care planning and advance directives Daily	Talk with your patients about advance care planning and advance directives A few times a week	Talk with your patients about advance care planning and advance directives A few times a month	Talk with your patients about advance care planning and advance directives A few times a year	Talk with your patients about advance care planning and advance directives Never/hardly ever
Manage chronic pain in your patients	Manage chronic pain in your patients Daily	Manage chronic pain in your patients A few times a week	Manage chronic pain in your patients A few times a month	Manage chronic pain in your patients A few times a year	Manage chronic pain in your patients Never/hardly ever
Manage non-pain symptoms in patients with chronic illness	Manage non-pain symptoms in patients with chronic illness Daily	Manage non-pain symptoms in patients with chronic illness A few times a week	Manage non-pain symptoms in patients with chronic illness A few times a month	Manage non-pain symptoms in patients with chronic illness A few times a year	Manage non-pain symptoms in patients with chronic illness Never/hardly ever
How often do you refer patients to the palliative care specialty/team?	How often do you refer patients to the palliative care specialty/team? Daily	How often do you refer patients to the palliative care specialty/team? A few times a week	How often do you refer patients to the palliative care specialty/team? A few times a month	How often do you refer patients to the palliative care specialty/team? A few times a year	How often do you refer patients to the palliative care specialty/team? Never/hardly ever
How often do you refer patients to the hospice team?	How often do you refer patients to the hospice team? Daily	How often do you refer patients to the hospice team? A few times a week	How often do you refer patients to the hospice team? A few times a month	How often do you refer patients to the hospice team? A few times a year	How often do you refer patients to the hospice team? Never/hardly ever

Question Title

* 2. What best describes you? (Check more than one if it applies)

PA student

1-5 years of practice

6-10 years of practice

11-20 years of practice

20+ years of practice

Retired from PA practice

PA program faculty

Administrative PA

Other (please specify if we missed a category that describes you)

Question Title

* 3. How would you describe your current practice profile? (You may choose more than one category if needed)

Family Medicine/general practice

General Surgery

Emergency Medicine

Internal Medicine

Dermatology

Hospital medicine

Pediatrics

Obstetrics/Gynecology

Urology

Cardiology

Oncology

Nephrology

Geriatrics

Medical or Surgical Subspecialty (please specify what describes you best)

Question Title

* 4. How would you describe the source or types of patients in your current practice profile? (You may choose more than one category if needed)

In-Patient population

Out-Patient population

Rural community population

Urban community population

Mixed In-and-Out Patient population

Multi-specialty group practice

Urgent Care center (separate from a hospital)

In-patient/long-term care population

Other (please specify or provide details on the above)

Question Title

* 5. As a PA student or a practicing PA, have you ever received any instruction or education in palliative and end-of-life care? (You may choose more than one if needed)

Yes - in PA school

Yes - in PA Post-Professional class/program

Yes - CME lectures

Yes - online programs/CME

Shadowing a Palliative Care provider

Not really

Other (please specify)

Question Title

* 6. What is your level of interest in additional palliative care skills training? You may answer more than once

	1 no interest	2 mild interest	3 moderate interest	4 extremely interested	5 actively seeking
CME lectures including a state or national conference	CME lectures including a state or national conference 1 no interest	CME lectures including a state or national conference 2 mild interest	CME lectures including a state or national conference 3 moderate interest	CME lectures including a state or national conference 4 extremely interested	CME lectures including a state or national conference 5 actively seeking
attend a palliative care conference on site	attend a palliative care conference on site 1 no interest	attend a palliative care conference on site 2 mild interest	attend a palliative care conference on site 3 moderate interest	attend a palliative care conference on site 4 extremely interested	attend a palliative care conference on site 5 actively seeking
attend a palliative care course online	attend a palliative care course online 1 no interest	attend a palliative care course online 2 mild interest	attend a palliative care course online 3 moderate interest	attend a palliative care course online 4 extremely interested	attend a palliative care course online 5 actively seeking
attend a palliative care webinar	attend a palliative care webinar 1 no interest	attend a palliative care webinar 2 mild interest	attend a palliative care webinar 3 moderate interest	attend a palliative care webinar 4 extremely interested	attend a palliative care webinar 5 actively seeking
grand rounds at a facility or hospital	grand rounds at a facility or hospital 1 no interest	grand rounds at a facility or hospital 2 mild interest	grand rounds at a facility or hospital 3 moderate interest	grand rounds at a facility or hospital 4 extremely interested	grand rounds at a facility or hospital 5 actively seeking
participate in a fellowship or preceptorship training program	participate in a fellowship or preceptorship training program 1 no interest	participate in a fellowship or preceptorship training program 2 mild interest	participate in a fellowship or preceptorship training program 3 moderate interest	participate in a fellowship or preceptorship training program 4 extremely interested	participate in a fellowship or preceptorship training program 5 actively seeking

Other (please specify why the above choices do not apply to you or add any pertinent details about your career)

Question Title

* 7. Indicate as many of these venues that you would be willing to attend for ongoing training in palliative care. This is important in our planning and request for support from institutions and other funding sources.

CME lecture(s) included at a state or national conference (example, AAPA, PAEA, APAO, AAHPM)

a palliative care course onsite

a palliative care course online

attend a palliative care webinar online

grand rounds at a facility/hospital

participate in a fellowship or preceptorship training

enroll in a palliative care curriculum/program online

Other (please give us more of your ideas!)

Question Title

* 8. Please tell us what state you practice in. This is important with regard to ongoing efforts to develop representation for the (Palliative Care Education and Training Act) PCHETA bill, which mentions support for physician assistant education, amongst other initiatives.

Northeast US

Southeast US

Southwest US

Northwest US

Please indicate the actual state in which you practice your palliative care skills as a PA