Are medical schools dealing with palliative care effectively?
HALLENBECK: Doctors here and elsewhere typically receive little training in pain management or in management of symptoms such as constipation, nausea and vomiting. Q: Why do you think there is so little education? HALLENBECK: In the most general terms, our medical school system emphasizes a disease model and tends to neglect areas such as pain management. One hundred years ago it was unnecessary to teach end-of-life care. People became acutely ill and usually died very quickly. Now with the exception of acute myocardial infarction, all of the most common forms of death that Americans experience involve at least several weeks to months of dying. The new Oxford Textbook of Palliative Medicine goes beyond the underlying diagnosis to list 53 relevant symptoms that occur in the terminally ill, ranging from shortness of breath to dry mouth. We can target these symptoms long after we are no longer targeting the underlying illness for cure or life prolongation. Q: Is anything being done now to
