While it is important to have specialty training programs to keep the discipline rigorous and to keep it progressing along with all the unprecedentedly powerful technical possibilities in palliative care, the key issue now is that few of our practicing professionals have been trained in the core skills. Core skills need to be defined and disseminated to physicians, nurses, social workers, pastors, pharmacists, and administrators. Within the nursing and physicians professions, these skills need to be defined and disseminated among all generalists and all specialists. There is no group of nurses and physicians who should be ignorant of the needs of palliative care toward the end of life. Dermatologists care for those with skin cancer.
Surgeons care for the dying routinely.
Many die in intensive care. Nurses have specialized skills for each of these and other categories of service. It is not possible to solve the problem with physicians alone but it is not possible to solve the problem without physicians. As physicians, we started this program to take proactive steps toward that portion of the solution that we bear responsibility for. Another key premise is that it is not possible to wait for medical school education to improve matters and send better trained doctors into the field.