Hospice and palliative medicine

Hospice and palliative medicine is a formal subspecialty of medicine in the United States that focuses on symptom management, relief of suffering and end-of-life care. In 2006, hospice and palliative medicine was officially recognized by the American Board of Medical Specialties, and is co-sponsored by the American Boards of Internal Medicine, Anesthesiology, Family Medicine, Physical Medicine and Rehabilitation, Psychiatry and Neurology, Surgery, Pediatrics, Emergency Medicine, Radiology, and Obstetrics and Gynecology. Physicians who complete a residency in one of the co-sponsoring specialties are then eligible for further training in an ACGME-approved Hospice and Palliative Medicine fellowship program, after which they must pass the official examination to be board-certified in the subspecialty. In 2007, the American Osteopathic Association Bureau of Osteopathic Specialists approved a Certificate of Added Qualifications (CAQ) in hospice and palliative medicine. Currently, the American Boards of Internal Medicine, Family Medicine, Neurology and Psychiatry, and Physical Medicine and Rehabilitation. Candidates are eligible for CAQ certification after achieving board-certification following an American Osteopathic Association-approved residency.

Scope of the Subspecialty
Physicians in this subspecialty have advanced knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting, life-threatening and terminal illnesses. This specialist has expertise in the assessment of patients with advanced disease and catastrophic injury, the relief of distressing symptoms, the coordination of interdisciplinary patient and family-centered care in diverse settings, the use of specialized care systems including hospice, the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. They work with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patients and family members throughout the course of the disease, including through the dying process and subsequent bereavement. This care can occur within or outside of a formal hospice or palliative care team.

Professional organization
The American Academy of Hospice and Palliative Medicine (AAHPM) is the leading professional organization for physicians subspecializing in hospice and palliative medicine in North America. The International Association for Hospice and Palliative Care is the major professional organization devoted to the global spread of hospice and palliative medicine.