Stan Horn nominated Dr. Widera after seeing first hand the care that his brother received at the hospice unit of the VA Medical Center. “At our first meeting, Dr. Widera told us that we could call him Eric and he gave us his pager number,” he wrote. Horn detailed how Dr. Widera continued that level of caring and compassion both in treating his brother and in talking with family and friends even after his brother’s death. “Dr. Widera has shown a significant and diversified degree of leadership and impact as a role model for other physicians in the community.”
As a clinician-educator at University of California, San Francisco, Dr. Widera has been a driving force in a number of innovations, including the creation of a monthly interdisciplinary palliative care conference at the medical center. He has received numerous awards for his educational accomplishments. Most recently, he has been examining the role social media plays in the education of professionals in palliative medicine and is a cofounder of geripal.org, an online forum for health professionals in geriatrics and palliative medicine.
Dr. Widera received his medical degree from University of California, San Francisco, in 2002.
Q and A With Eric Widera
How is the importance of palliative care changing?
Specialty palliative care is no longer an optional service for a hospital. We now know that palliative care improves outcomes for individuals living with serious illness and their family members. This includes improving quality of life, symptom burden, Advance Care Planning, patient and caregiver satisfaction, and health care costs. The field of palliative care now needs to address improving access outside of hospital settings to places to where palliative care hasn’t really yet reached, including nursing homes and rural areas.
How do you think the field of palliative medicine helped during the pandemic?
One way it helped was being there for the many critically ill patients with COVID-19 who needed specialty-level palliative care that included managing symptoms, conducting goals of care conversations, and facilitating medical decision making in ethically and emotionally charged situations. We also learned that we can do this through a scalable virtual consultation model staffed by volunteer specialists who even live out-of-state. For example, during the apex of the COVID-19 crisis in New York, the Adult Palliative Care Service at Columbia University Irving Medical Center (CUIMC)/NewYork-Presbyterian (NYP) received a sevenfold increase in consultation requests. This unprecedented increase in demand outpaced the palliative care team’s ability to respond. We helped develop a high-quality specialist-level palliative care volunteer service that spanned institutional and state boarders to meet this need (which was published in this article – https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.16643 )
In your opinion, what is most misunderstood when it comes to Palliative Care?
I still hear from colleagues that patients “are not ready for palliative care.” It’s my biggest pet peeve about misunderstandings about palliative care. What they are really saying is that someone isn’t ready for end-of-life care, but palliative care is so much more than that. The elements of palliative care, including skilled communication about what to expect in the future and safe management of pain and other symptoms, can be delivered at any point in someone’s serious illness in order to improve their quality of life.
What have you found helpful in explaining Palliative Care and Advanced Care Planning to elderly patients?
I used to spend a lot of time explaining palliative care when I meet a patient and family for the first time. I’ve changed overtime as I feel like the best way to explain what I do is to show them how I can help overtime. So now I give a short definition of what we do, and then get down to listening to the patients how they are coping with their illness.
What might the impact be to our health care system if we were less reluctant to face advance care planning and decisions before illness or injury strike?
2020 has taught us a lot, including that differences matter. This theme also comes to bear when we think about health care decisions. When we don’t ask what’s important to people we end up with disrespecting the diversity in beliefs, backgrounds, and preferences of our patients and family members. This results in a one-size fits all approach to medicine that is only some people fit into, and causes both underutilization and overutilization of health care resources.
Will you talk a bit about the American Academy of Hospice and Palliative Medicine and your work with AAHPM?
Throughout my academic career I’ve been very involved with AAHPM, something that I’ve always felt was a relationship that the more I put into it, the more I got out of it. I’m currently in my second term as a Director-at-large on the AAHPM Board of Directors, a position where I truly get to see the value of all our members contributions. Their energy and commitment to AAHPM and to the field of palliative care is truly inspiring, and has led to improvements from a policy, education, research, and clinical perspective.
Are you working on any research projects or have you published recently that you’d like to share?
We just published an article and video in the New England Journal of Medicine (NEJM) that teaches health care providers on how to facilitate a family meeting on behalf of patients with serious illness. It’s free for anyone to download and watch (or incorporate in their own teaching). https://www.nejm.org/doi/full/10.1056/NEJMvcm1913056
If people would like to reach you directly for additional information or assistance, how would they do so?
I’m very active on social media. Tweet me at @ewidera! Or you can go old school and email me at eric.widera@ucsf.edu