Parkland Palliative Care program marks 20-year anniversary
First in Dallas and among largest in the U.S.
Twenty years ago, the subspecialty of Hospice and Palliative Medicine didn’t exist in the U.S. and there were no palliative care programs in Dallas. But a compassionate and committed young physician at Parkland Health & Hospital System had a vision. Elizabeth Paulk, MD, who joined the faculty of UT Southwestern Medical Center in 1999, approached leadership at Parkland and UT Southwestern with her idea.
“I want to start a clinic for people with terminal illness,” she said.
Now marking its 20th year of service to patients and families facing a long-term illness, Parkland’s Palliative Care program was one of the first in the state and remains one of the largest in Texas and the U.S. It is still led by Dr. Paulk, who has dedicated her career to providing the highest possible quality of palliative care to Parkland’s sickest patients and their families, most of them with limited financial resources.
“Parkland’s Palliative Care team is an example of our values at work: they provide compassionate care to all patients, ensuring that the intrinsic value of every human being is recognized,” said Roberto de la Cruz, MD, Chief Medical Officer at Parkland. “Being a palliative care practitioner is a great honor and requires special skills. Our patients are fortunate to have a program of such depth, caliber and passion.”
“Learning that you or a loved one has a serious or life-threatening illness can be terrifying. But referral to palliative care services should not be,” Dr. Paulk said. “What I find is that people are most afraid of the unknown. Information presented in a straightforward and realistic way is very helpful when dealing with a new and frightening situation. What we tell patients is, ‘Don’t be scared. You’re not alone. We’ve walked this path before and we’re going to walk it with you.’ Our mission is to ensure their physical, spiritual and emotional comfort.”
Adelfa Lorilla, MD, of Seagoville is a grateful family member of a Parkland patient assisted by Parkland’s Palliative Care Clinic. “Even health professionals can feel overwhelmed when providing care for a family member,” she said. A pediatrician, Dr. Lorilla became the full-time caregiver for her husband Ricardo when he was gravely ill with COPD.
“The Palliative Care staff at Parkland gave us so much help and comfort during his last years,” she said. “They made sure we had everything we needed and were like family to us. People have to remove the idea that palliative care will be the end of everything for them,” said Dr. Lorilla.
Since inception, the Palliative Care program has provided services to an estimated 20,000 patients. In FY 2018, the program had more than 12,525 patient encounters at Parkland Memorial Hospital. Working in one of the nation’s largest safety net hospitals, Dr. Paulk and her team assist patients ranging from age 18 to over 100 and of many ethnicities. Approximately one-third of patients are Hispanic, one-third African-American and the remainder of Caucasian, Asian or other backgrounds. Most have been diagnosed with cancer, heart failure, COPD, renal or liver disease. The Palliative Care Clinic operates five half-days weekly and inpatient consult services are available by phone 24/7.
“One of the most important things we do is give patients more control over their care by helping them understand their treatment choices. We don’t just provide pain management. We meet the patient where they are, psychologically as well as physically, and work with their medical specialists like oncologists or cardiologists, to help the patient live as well as possible and to help them make good choices about their care,” Dr. Paulk said.
Providers include nurse practitioners, social worker, chaplain, psychologist, pain management specialist, pharmacist, physical therapist, bereavement coordinator, medical assistants and others. The team arranges for hospice care when needed, and stays in touch with patients and family members during final stages of illness. Parkland offers a bereavement program and grief support groups in English and Spanish for family members.
Regardless of language, the message from Dr. Paulk and the Palliative Care team is the same. “This is about life – how you want the rest of your life to be and how we can help you get that.”
“Spirituality plays a major role in how many patients deal with illness and dying,” Dr. Paulk said. “We are very humble about the reality that we as medical professionals speak from a scientific perspective. Our approach to treatment is to help anyone who is trying to live well in the face of serious illness and to keep them as healthy as possible. We know we don’t have control over everything.”
Though they work closely together and are often confused in the public’s mind, palliative care and hospice programs are not the same. Palliative care provides patients relief from the symptoms, pain and stress of a serious illness, regardless of the diagnosis or stage of illness, and can be combined with curative treatment. The goal is to improve quality of life for both patient and family. Hospice offers supportive care to people in the final phase of terminal illness.
“Palliative care focuses on control of symptoms like pain, fatigue or shortness of breath and also addresses the emotional, spiritual and social needs of the patient and family,” Dr. Paulk said.
“I have the best job in the world because I get to help people feel better,” Dr. Paulk concluded. “I get to come to work every day and talk to people about what’s most important in their lives - not waste time on things that don’t matter. We’re here to take care of people and we’re here because we want to be.”
For more information about Parkland services, please visit www.parklandhospital.com
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