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Diane E. Meier: Palliative Care Pioneer

Carrie Vaughan, for HealthLeaders Media, December 2, 2010

"It is a way to prolong life and improve its quality and reduce unnecessary spending."

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is Diane E. Meier's story.

After years of working in acute care hospitals, Diane E. Meier, MD, who finished her training as a geriatrician in 1983, found that despite medical professionals' best intentions and zeal to cure diseases and prolong life, many had lost sight of the human being inside the illness.

"The American healthcare system has had a single-minded focus on the application of drugs and technology and procedures to prolong life, and attention to the quality of that life has been lagging," says Meier. "Sometimes those working in hospitals can forget that most of the illness happens outside of the hospital and that the people holding the bag are the families who take care of these frail people, and it is part of our obligation to make sure that there is an effective safety net around that patient and family when they leave the hospital doors."

There is a need to enhance medical professionals' skills to identify and treat distressing symptoms such as pain and fatigue; to communicate with the patient, family, and other caregivers about the treatment options and determine a course of treatment based on individual patient goals and preferences; and to help patients navigate the continuum of care so they know what to expect and have a support system when they leave the acute-care setting, says Meier, who is the director of the Center to Advance Palliative Care and the director of the Hertzberg Palliative Care Institute at Mount Sinai School of Medicine in New York where she is also a professor of geriatrics and internal medicine.

Fortunately, she says that social workers, physicians, nurses, and the public recognized that patients were falling through the cracks of this treatment-oriented healthcare system, including private sector philanthropic organizations such as the Robert Wood Johnson Foundation and George Soros' Open Society Institute. Combined, those organizations invested nearly $250 million during a 20-year period to help establish this field of medicine, says Meier.

In 1999, RWJF also recruited Meier and her colleague, Christine K. Cassel, MD, to head the Center to Advance Palliative Care, which provides technical assistance, tools, and peer support to frontline physicians and hospitals wanting to start palliative care programs.

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