I am sure that the title of this editorial conjures up disparate definitions and concepts. As surgeons, we have all provided surgical care for patients who were not destined to survive their illness, but needed relief from pain, bowel obstruction, airway compromise and many other maladies that affect quality of life. One of the beliefs that continues to linger is that palliative care equates with hospice care. One of my goals during a career in surgical oncology has been to dispel the notion that palliative care is synonymous with end-of-life supportive care in cancer patients. The standards developed by the American College of Surgeons (ACS) Commission on Cancer Accreditation Program have also sought to support this differentiation.
For many years, surgeons have been at the forefront of palliative care and alleviation of suffering for many diseases, not only cancer. Surgeons in every discipline have had multiple opportunities to participate, through operative and nonoperative means, to relieve pain and to enhance quality of life. In fact, the concept of “palliative medicine” was started by the Canadian surgeon and urologic oncologist, Balfour Mount. Surgeons exemplified by Geoffrey Dunn, Robert Milch and Anne Mosenthal have promoted the ideals of surgical palliative care in the United States, and have encouraged its importance through the ACS and other surgical organizations.
Over the past several years, surgeons have incorporated palliative care concepts into their practices. In fact, approximately 90 surgeons in the United States have become board certified in Hospice and Palliative Medicine. These driving forces merged during the 2019 ACS Clinical Congress, when a small group met over dinner to create a new movement that would further enhance the principles of surgical palliative care. These “thought leaders” laid the foundation for a new society—the Surgical Palliative Care Society (SPCS).
Three surgeons, Melissa Red Hoffman, Pringl Miller and Buddy Marterre, all boarded in Hospice and Palliative Medicine, formulated a plan to create an interdisciplinary organization devoid of disciplinary boundaries that would embrace the spectrum of the health care team, including surgeons, nurses, social workers, chaplains and pharmacists who had interests in banding together to promote the surgical palliative care movement. The SPCS would have, as its principal goals, mentorship, education, research and advocacy in surgical palliative care. This overall mission would be a driving influence to mandate early promotion of surgical palliative concepts into every disease managed by surgeons.
Now, you may be thinking: Why another surgical organization? Why not intercalate palliative medicine principles into other existing organizations? In my view, although every specialty surgical organization should embrace these concepts, the importance of palliative care in surgery deserves its own mission-driven organization. I salute these dedicated surgeons who have worked diligently to teach and advocate for surgical palliative care. The principles they champion should be inculcated into every surgically related organization and residency training program. The Surgical Palliative Care Society is just the group to see that it happens!
Dr. Greene is a surgeon in Charlotte, N.C.
This article is from the September 2021 print issue.
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