Surgeons require additional palliative care education

Physicians who received no palliative care training appeared considerably more likely to recommend major surgical interventions for patients with advanced cancer, according to new study results.

Richard Bold, MD, chief of surgical oncology at UC Davis Comprehensive Cancer Center, and colleagues surveyed 102 surgeons and medical physicians who treat patients with advanced cancer who had symptomatic surgical conditions. Researchers assessed respondents’ palliative care training and surgical decision-making.

The researchers hypothesized that surgeons would have less palliative care training and, thus, provide more aggressive treatment recommendations.

Surgeons reported fewer hours of palliative care training (median, 10; interquartile range [IQR], 2-15) during residency, fellowship and CME combined than medical oncologists (median, 30; IQR, 20-80) and medical intensivists (median, 50; IQR, 30-100; P < .05). Twenty percent of surgeons reported no palliative care training. Survey respondents who had no palliative care training recommended major operative intervention significantly more frequently than those who had undergone 40 hours or more of palliative care training (P = .01). “These findings highlight the need for greater efforts systemwide in palliative care education among surgeons, including incorporation of a structured palliative care training curriculum in graduate and continuing surgical education,” Bold and colleagues wrote.

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