Fellows in our program experience the full breadth of palliative medicine through a longitudinal schedule. Apart from off-site rotations (such as pediatrics or electives), all fellows participate in all sites of care on a regular basis, providing a unique opportunity to develop a panel of patients seen with continuity across multiple care settings, as follows:
Inpatient Palliative Care Consult Service:
Fellows will join our interdisciplinary inpatient consult team, consisting of attending physicians, nurse practitioners, a social worker, and a registered nurse. Our consult service is asked to assist with a diversity of clinical issues, including:
Complex medical decision making/decision support for acute medical issues or changing goals of care
- Complex pain and symptom management in the setting of serious illness
- Provision of psychosocial support to patients and families
- Complex care coordination for patients suffering from serious illness
Outpatient Palliative Medicine Ambulatory Office Practice
Fellows maintain an active ambulatory practice, with at least twice-monthly sessions in partnership with an attending physician, social worker, and other members of the interdisciplinary team. Currently, our clinics are co-located in the oncology and family medicine practices, providing unique opportunities for collaboration and co-management of complex patients. Fellows will also participate in our growing telemedicine practice, in an effort to reach more homebound patients, and will also have the opportunity to conduct home visits as needed.
Einstein Montgomery Hospice
Einstein Montgomery Hospice is an integrated hospice agency within the Einstein Montgomery system with a long history of service to our community.
Fellows regularly visit home hospice patients, with a focus on following their own patients should they elect the hospice benefit. In addition, fellows see a diversity of patients with our RN-case managers, hospice social worker, and hospice chaplain, to develop a full understanding of the hospice interdisciplinary team.
Fellows also develop the skills necessary to act as a Hospice Medical Director (HMD) through regular attendance of hospice interdisciplinary team meetings. As the year progresses, fellows lead these meetings and fulfill the administrative responsibilities of hospice care with increasing autonomy, under the supervision of faculty.
Finally, fellows regularly round on inpatient hospice patients who receive acute hospice care at EMCM, providing additional opportunities to practice complex pain and symptom management skills and to recognize and manage the syndrome of imminent death.
In addition to these core rotations, fellows participate in the palliative care of patients residing at local skilled nursing facilities. Fellows also experience pediatric palliative care at various sites, including at St. Christopher's Hospital for Children.