"I am in the field of palliative care because of the day-to-day gratification of knowing I make a difference every day. Palliative care doesn’t save lives per se, but it can make a huge difference.”Institution
--Richard Payne, MD
Pain and Palliative Care Service
The service sees between 10 to 24 outpatients per day and 10 to 35 inpatients.
Richard Payne, MD
Program Mission and Objectives
Leadership through excellence
The program encourages the patient’s family to participate, but ultimately, the level of participation is up to the patient. There are no formal programs for family other than bereavement services.Historical Perspective
In the mid-1970s, Kathleen Foley, MD, and Raymond Houde, MD, began seeing patients with pain in the outpatient medical clinic. Foley then started an inpatient pain consultation service in the Department of Neurology; the founding chair supported her efforts. This program was called the Pain Service. A training program for fellows, an observership program and a research program began in the late 1970s.
In 1981, Memorial Sloan Kettering Cancer Center (MSKCC) developed the Supportive Care Program for patients at home. Initially, this program was supported by philanthropic funds. In 1985, the hospital assumed its funding. In 1996, the name of the Pain Service was changed to the Pain and Palliative Care Service, reflecting the fact that the service had broadened its mission to encompass additional physical symptoms including fatigue, depression and psychological distress, dyspnea, etc. In February 2000, the service opened an inpatient unit.Research
The Pain and Palliative Care Service trains three to six fellows each year and is the primary clinical site for Cornell medical students doing their two-week rotation in palliative care and ethics. The service also has an NIH-funded observership program and a nursing fellowship program.
Richard Payne and his colleagues have a grant to develop a palliative care program at North General Hospital. They also work on joint research projects with Beth Israel Hospital and Calvary Hospital.
The service does fundraising but no marketing at this time.
The Pain and Palliative Care Service is funded by Hospital support (6%), foundation grants (25%), endowments (5%), and federal grants (5%).
Richard Payne’s long-term vision is to maintain the excellence this program has already achieved in clinical services and research. He would also like to develop two additional programs: a palliative care unit (and perhaps a hospice unit) and a rehabilitation unit as part of pain and symptom management. Cancer patients can have significant functional limitations from the disease or from therapy and are not necessarily treated optimally in conventional rehabilitation units.
A National Perspective
Elements and Measures of Program Success
“I naively took for granted that other health care providers would see the logic and the need for what we do and therefore things would be easy. I wish I had been savvier about the professional and emotional barriers to integrating palliative care. After 20 and 30 years, there are still doctors who don’t get it. They think it’s an either-or situation—they can’t be a good surgeon, for example, and worry about pain, too.”
----Richard Payne, MD
This descriptive summary is based on an interview conducted by
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