I'm Not a Doctor

A second opinion on the challenges and opportunities facing today's physicians.

Fishing for a supportive name change

12:45 pm, Mar. 6

The term "palliative care" may soon become as well-known as "Chinese gooseberry" and "slimehead."

Chinese gooseberry is what kiwifruit was once known as, back in the days when it wasn't very popular. According to the Purdue University Center for New Crops and Plant Products, New Zealand growers started calling it kiwifruit around 1962, but the name wasn't commercially adopted until 1974. And now, kiwifruit is an essential element of fruit salads everywhere. (Curiously, the Chinese name for the fruit literally translates to "strawberry peach," which sounds like a popular flavor of cheap wine or the latest blend of expensive vodka for the dangerously trendy. … But I digress.)

It is possible to be too popular. The fish originally called slimehead has seen a hazardous spike in popularity now that people know it as orange roughy. In fact, some fear it has become so in demand that it may be overfished out of existence. The same is true of the Patagonian toothfish, now known as the Chilean sea bass.

I bring this up because, on its OncoLog Web page, the University of Texas MD Anderson Cancer Center reports that the term "palliative care" has been popularly misinterpreted as exclusively for patients transitioning into end-of-life comfort treatments. MD Anderson's Dr. Eduardo Bruera, however, is quoted as saying palliative care is intended for any patient with a serious chronic or life-threatening illness.

After a 2007 survey found that the term "palliative care" deterred physicians from referring patients who had early-stage cancer or were receiving active treatment, MD Anderson's Palliative Care and Rehabilitation Medicine Center's name was changed to the Supportive Care Center.

The name change not only reportedly led to a 40% increase in referrals, but also patients now come in for treatment a month and a half earlier than they did before. "We believe these improvements are because clinicians feel more comfortable referring their patients to a place called 'supportive care,' which is not closely associated with the end of life," Bruera told OncoLog.

The term "patient-centered medical home" has had its own share of troubles. Meant to describe a physician practice with a focus on team-based care coordination and improved communication and access, the label is mistakenly associated with nursing and funeral homes, research has shown.

This gives providers a lot to discuss over their lunch of Chinese gooseberries, slimeheads and Patagonian toothfish.

Follow Andis Robeznieks on Twitter: @MHARobeznieks.


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