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EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
Osteopathic EPECOsteopathic EPEC Osteopathic EPECOsteopathic EPEC Education for Osteopathic Physicians on End-of-Life
Care
Based on The EPEC Project, created by the American Medical Association and supported by the Robert Wood Johnson
Foundation. Adapted by the American Osteopathic Association for educational use.
American Osteopathic AssociationAOA: Treating Our Family and Yours
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
Objectives
• List the important themes from the EPEC materials
• Identify barriers to good end-of-life care
• Develop potential solutions
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
EPEC themes, next steps• Relief of suffering is a goal of
medical care
• Palliative care knowledge is now extensive
• Role of families
• Teamwork
• Physician as patient advocate
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
Relief of suffering
• 4 dimensions of suffering• Physical
• Psychological
• Social
• Spiritual
• Expected by patients, families
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
Palliative care
• Not the absence of care
• More powerful than ever in the history of medicine
• A positive, humanistic philosophy
• Technically sophisticated area of expertise
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
Osteopathic Philosophy• Treatment of the entire person
• Utilize all available medical procedures and technologies
• Understanding of relationship to structure and function
• Utilization of osteopathic manipulative treatment options
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
Families . . .
• How we die is an important personal legacy
• Dying well often demands• The chance to be close to family,
friends
• Family / proxy assistance with decisions
• Good communication
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
. . . Families
• None of this is possible without good symptom management
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
Teamwork . . .• The whole person goes
through the dying process, not just his / her physiology
• No one person can meet all the needs
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
. . . Teamwork• Teamwork usually includes
• Physicians• Nurses• Social workers• Chaplains• Others
• Hospice philosophy can be integrated into mainstream practice
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
Advocacy
• Professional duty to patient care
• Professional duty to ensure availability of services
• Personal desire to be able to die with quality care
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
Barriers
• Institutional
• Regulations
• Reimbursement
• Attitudes
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
Physicians’ personal support needs . . .• Patients are asking us to do
better
• Find a forum for candid discussion of experiences
• Transference is powerful; personal comfort is important
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
. . . Physicians’ personal support needs• Professional distance,
empathic closeness must balance
• Know yourself
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
Action Plan
Barrier Plan
EEPPEECC
American Osteopathic AssociationAOA: Treating Our Family and Yours
Barriers
• “I” = Institutional
• “O” = Others
• “U” = Personal
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