223236 Are Mandates the Answer? Improving Palliative Care and Pain Management (PC/PM)

Tuesday, November 9, 2010

Mckalyn Leclerc , University of Vermont College of Medicine, Burlington, VT
Patrick Butsch , University of Vermont College of Medicine, Burlington, VT
Laura DePouli , University of Vermont College of Medicine, Burlington, VT
Nicholas Larochelle , University of Vermont College of Medicine, Burlington, VT
Michael Maccini , University of Vermont College of Medicine, Burlington, VT
Michael Morwood , University of Vermont College of Medicine, Burlington, VT
Andrea Steely , University of Vermont College of Medicine, Burlington, VT
William Wargo , Board of Medical Practice, Vermont Department of Health, Burlington, VT
Thomas V. Delaney, PhD , Pediatrics, VCHIP, University of Vermont College of Medicine, Burlington, VT
Virginia Hood, MBBS, MPH , University of Vermont College of Medicine, Burlington, VT
George Philips, MD MPH , University of Vermont College of Medicine, Burlington, VT
Jan K. Carney, MD MPH , University of Vermont College of Medicine, Burlington, VT
Introduction. In January 2009, the Vermont legislature passed a bill to improve quality and access to palliative care and pain management (PC/PM) resources in the state. In collaboration with the Vermont Board of Medical Practice, we assessed various aspects of PC/PM among Vermont physicians. Methods. We created and distributed 1810 surveys to VT-licensed physicians after reviewing the literature and other states' PC/PM requirements. We gathered responses by postal mail and online via SurveyMonkey®, with a collection time of 26 days. Results. 303 responses (17%) were representative of Vermont physician demographics. Over 75% of respondents answered PC/PM questions competently and felt confident dealing with multiple facets of PC/PM. Physicians were generally satisfied with the PC/PM their patients receive; however, 61% of physicians were unfamiliar with the Patients' Bill of Rights for PC/PM. The largest reported barrier to PC was the belief systems of patients and their families. We also found that 50% of physicians strongly disagree that mandatory CME credits in PC/PM would improve quality of care, while only 18% strongly agreed. Nonetheless, physicians stated they would be most likely to utilize online modules and database/provider networks to access PC/PM information. Conclusions. Vermont physicians appear competent and confident in PC/PM. Data do not support implementing mandatory PC/PM CME credits at this time. Instead, Vermont should offer online educational modules and a PC/PM provider database, as well as address the lack of awareness of the Patients' Bill of Rights for PC/PM. Our methods and findings may be applicable to other states.

Learning Areas:
Advocacy for health and health education
Clinical medicine applied in public health
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
1. Discuss the role of state legislatures in palliative care and pain management 2. Describe methods used to gather information from physicians related to palliative care and pain management 3. list findings, conclusions, and implications for other states

Keywords: Access to Health Care, Health Law

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a medical student in Vermont, and I participated in the design, implementation, and analysis of the study and helped create the poster summarizing the study and its findings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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