Community-Based Palliative Care Implementation in the San Francisco Department of Public Health
Public health systems have historically lagged behind similarly sized not-for-profit health systems in developing palliative care services. In the city and county of San Francisco, residents who depend on the San Francisco Health Network (organized under the SF Department of Public Health) currently have no access to specialty palliative care services outside of one acute care hospital and one skilled nursing facility. This project will explore and implement community-based palliative care across the SF Health Network. Activities include: a comprehensive needs assessment across the system, examining cancer patients' utilization patterns in the last months of life, developing a plan for sustaining an ongoing program, and becoming a model for other public health systems across the country.
I entered my residency determined to practice as a primary care physician. As I went through my training, though, I realized that the moments that felt most important, most fulfilling and most consistent with my strengths were all related to care of patients with serious illness. This led me to train in Hospice and Palliative Medicine. I continue to be awestruck by the sacredness of the moments we are invited into when practicing palliative medicine. I learn from my team and from my patients and their families every day, absorbing new information about culture and tradition, family systems, and the practice of medicine. Although we sit with patients and families in the midst of pain and tragedy, I am compelled by the idea that, if I do my job well, I or my team can often do something to lessen their suffering in some small way. After several years as a clinician, I still regularly reflect on the tremendous privilege I have in doing this work.
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