NephMadness 2016: Commentary on Palliative Care Nephrology
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Conservative Care in ESRD vs Stopping Dialysis
This is a match up for the ages. A match up so intense it may alter how others decide to play the game in the future. Our pick—the Conservative Care in ESRD team. This team is all about strategizing. The coaches consider patients as integral players. You may not see this team out on the floor, running drills, and practicing free throws so you may doubt their ability—but you would be mistaken. You will find this team in the locker room, taking time to discuss and learn about the overall goals and wishes of the patients. They don’t look at the goal of the game as dialysis—instead they are focusing on other important patient centered outcomes such as functional status and quality of life. They aren’t afraid admit that uncertainty exists, and that they would benefit from more structured evidence regarding the conservative management approach and outcomes. But this team is full of heart. Their patients live supported by all members of the managerial staff and spend more time enjoying the game than sitting on the bench recovering from fatigue and hospitalizations. Though this team is young, they are gaining momentum and have the potential to go all the way.
Palliative Care Consultation vs Primary Palliative Care
The primary palliative care team has the motivation and determination, but needs a couple more seasons in the big leagues to hone their skills to be able to take on the talented Palliative Care Consultation team. This year’s pick—Palliative Care Consultation. The Primary Palliative Care team needs to learn more skills early on when team members are in the junior leagues and they need practice. They need to be willing to step outside their comfort zone, like being able to share prognosis with patients. Ready or not, the Primary Pallaitive Care team has to step up and start playing with the pro’s because there are a lot more games that need to be played than the Palliative Care Consultation team can participate in. They have the potential; they just need a little encouragement from the fans.
Holly Koncicki, MD
Hofstra Northwell School of Medicine, NY, USA
Dr. Holly Koncicki completed her medicine residency at Mount Sinai Hospital, followed by completion of an integrated fellow in nephrology and palliative medicine. She is currently appointed as Assistant Professor of Medicine at the Hofstra Northwell School of Medicine. She has researched and published in the role of Palliative Care in Nephrology. She serves on the international KDIGO workgroup for Supportive Care with focus on symptom management. “
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