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AllanRamsayMD
(Physician
- Internal Medicine
(Verified)
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| Communities: Breast Cancer | Thank You's: 1 |
| Member Since: Dec. 2011 | Questions: 0 |
| Answers: 6 |
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Professional Statement
Dr. Allan Ramsay is the Director of Palliative Care Services at Fletcher Allen and Professor at the University of Vermont College of Medicine
Professional Info
Credential:
MD
Primary specialty:
Internal Medicine
Secondary specialty:
Geriatrics
Medical school:
Emory University School of Medicine
Residency:
Emory University School of Medicine
Internship:
Emory University School of Medicine
Areas of expertise:
Palliative Care, Geriatric Medicine
Hospital affiliation:
Fletcher Allen Health Care
Practice address:
111 Colchester Avenue
Burlington, VT
05401-1473
Practice phone number:
802-847-5536
Personal Bio (My story)
Before I became a palliative care physician I was a family doctor for 30 years. Family physicians care for people through the entire life cycle- birth to death. Now I focus on making the last phase of our lives as full and productive as it can be. In this role, I find that my relationships with my patients and their families are very different – but equally rewarding.
AllanRamsayMD Activities
It is very common for a family to be faced with making difficult decisions about end of life care. The palliative care service can be helpful in this situation. Palliative care services are experts at being sure the right medications are being used to provide comfort and awareness, coordinating family meetings, and discussing prognosis. They can also assist in weighing the benefits or risks of a life supporting therapy such as going on a ventilator or dialysis. Having an advanced directive that designates a surrogate decision maker is important but many do not have one when a crisis occurs.
It is very common for a family to be faced with making difficult decisions about end of life care. The palliative care service can be helpful in this situation. Palliative care services are experts at being sure the right medications are being used to provide comfort and awareness, coordinating family meetings, and discussing prognosis. They can also assist in weighing the benefits or risks of a life supporting therapy such as going on a ventilator or dialysis. Having an advanced directive that designates a surrogate decision maker is important but many do not have one when a crisis occurs.
New answer by AllanRamsayMD (Physician - Internal Medicine (Verified)) in topic(s) Palliative Care, End Of Life Decisions, Advanced Directives, End Of Life
3
Answers |
4 months ago
Palliative care is not associated with any specific length of life or prognosis. In other words, palliative care is not always end of life care. We have a great program for end of life care, called hospice. When a person has a median life expectancy of six months they become eligible for the Medicare Hospice Benefit (if enrolled in Medicare). Another way to understand the difference is: all hospice care is palliative in nature but not all palliative care is hospice. People can benefit from palliative care at any stage of their disease process.
Palliative care is not associated with any specific length of life or prognosis. In other words, palliative care is not always end of life care. We have a great program for end of life care, called hospice. When a person has a median life expectancy of six months they become eligible for the Medicare Hospice Benefit (if enrolled in Medicare). Another way to understand the difference is: all hospice care is palliative in nature but not all palliative care is hospice. People can benefit from palliative care at any stage of their disease process.
New answer by AllanRamsayMD (Physician - Internal Medicine (Verified)) in topic(s) Palliative Care, Hospice
1
Answer |
4 months ago
Palliative care is a specialty that provides multidisciplinary expertise in symptom management, establishing a prognosis, assisting patients and families in setting goals of care, and helping patients make decisions about the benefits or risks of burdensome life supporting therapies. Most large hospitals and cancer centers now have palliative care consultation services available. There are also growing numbers of outpatient palliative care clinics. The most common reason to consult a palliative care expert is to control a difficult symptom such as pain, shortness of breath, constipation, anxiety, or depression.
Palliative care is a specialty that provides multidisciplinary expertise in symptom management, establishing a prognosis, assisting patients and families in setting goals of care, and helping patients make decisions about the benefits or risks of burdensome life supporting therapies. Most large hospitals and cancer centers now have palliative care consultation services available. There are also growing numbers of outpatient palliative care clinics. The most common reason to consult a palliative care expert is to control a difficult symptom such as pain, shortness of breath, constipation, anxiety, or depression.
New answer by AllanRamsayMD (Physician - Internal Medicine (Verified)) in topic(s) Palliative Care, Cancer Palliative Care, Cancer
1
Answer |
4 months ago
Cancer care should be evidenced based, integrated with palliative care, and be the model for patient-family centered care. Cancer not only affects the individual but also the family. Studies have shown that when palliative care is introduced at an earlier time in the care of lung cancer, the patients with palliative care as well as their usual oncology care have better quality outcomes and live longer than those without a palliative care provider. I am sure this intervention would also apply to many other types of cancer. So the best way to improve quality and reduce spending is the integration of oncology, primary, and palliative care.
Cancer care should be evidenced based, integrated with palliative care, and be the model for patient-family centered care. Cancer not only affects the individual but also the family. Studies have shown that when palliative care is introduced at an earlier time in the care of lung cancer, the patients with palliative care as well as their usual oncology care have better quality outcomes and live longer than those without a palliative care provider. I am sure this intervention would also apply to many other types of cancer. So the best way to improve quality and reduce spending is the integration of oncology, primary, and palliative care.
New answer by AllanRamsayMD (Physician - Internal Medicine (Verified)) in topic(s) Health Care Costs, Palliative Care, Reducing Health Care Costs, End Of Life
1
Answer |
4 months ago
There have been amazing advances in how we manage most cancers over the past twenty years. People who would have had a very limited life expectancy in the past now are living for many years, even with later stages of cancer. We have also developed technologies that carry a heavy burden at the end of life. We can keep people alive on a variety of “machines” without really adding to their meaningful life. Many patients tell me “I want everything done to stay alive”. That is very understandable; however it must be balanced with a discussion of the other things that are important to them. Advanced directives are a way to have that discussion and avoid unnecessary suffering for patients and families.
There have been amazing advances in how we manage most cancers over the past twenty years. People who would have had a very limited life expectancy in the past now are living for many years, even with later stages of cancer. We have also developed technologies that carry a heavy burden at the end of life. We can keep people alive on a variety of “machines” without really adding to their meaningful life. Many patients tell me “I want everything done to stay alive”. That is very understandable; however it must be balanced with a discussion of the other things that are important to them. Advanced directives are a way to have that discussion and avoid unnecessary suffering for patients and families.
New answer by AllanRamsayMD (Physician - Internal Medicine (Verified)) in topic(s) Palliative Care, Advanced Directives, End Of Life
1
Answer |
4 months ago
Vermont passed legislation in 2011 which was designed to bring health care costs under control by developing a fully integrated system that would cover all Vermonters. There were three phases to the legislation. The first was the creation of the Green Mountain Care Board. This five member board, appointed by the Governor, has broad powers including approval of all hospital budgets, insurer rates, and development of a universal benefit package for all Vermonters. The general principle is that we must move away from fee-for-service reimbursement and toward a system that rewards quality and value.
Vermont passed legislation in 2011 which was designed to bring health care costs under control by developing a fully integrated system that would cover all Vermonters. There were three phases to the legislation. The first was the creation of the Green Mountain Care Board. This five member board, appointed by the Governor, has broad powers including approval of all hospital budgets, insurer rates, and development of a universal benefit package for all Vermonters. The general principle is that we must move away from fee-for-service reimbursement and toward a system that rewards quality and value.
New answer by AllanRamsayMD (Physician - Internal Medicine (Verified)) in topic(s) Health Care, Vermont, Reducing Health Care Costs, Health Care Policy, Health Care Costs
1
Answer |
4 months ago
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