Perioperative Palliative Care by Dr Ramachenderan
This is a quick shout out to my good friend, fellow GP Anaesthetist and all round nice chap – Dr Johnathon Ramechederan.
He has co-authored this great article in the Journal of Pain and Symptom Management with fellow Albany doctor Kirsten Auret. It is about how we treat patients with surgical needs towards the end of life.
Johnathon has a great passion for the compassionate and rational management of older patients and manages to combine his Anaesthetic and Palliative care knowledge to negotiate some of the most difficult situations that we face as hospital clinicians.
Please have a read of the article (linked here) and comment, ask questions and let us know how you manage these important moments in medicine.
Palliative Care Rounds
The Challenge of Perioperative Advance Care Planning
Jonathan Ramachenderan, MBBS, FRACGP, and Kirsten Auret, MBBS, FRACP, FAChPM
This is an excellent article, and shows complex care and decision making at its best. Only one aspect was unclear – the timeframe within which the plan was made for this patient. I commend the primary doctor on being able to bring together several specialties, enable a conversation in terms that the patient and family could understand and get a sensible decision all within the urgency of surgery for ischaemic bowel.
I would be interested to know about the prior groundwork that would have taken place to foster these relationships between consultants and render them amenable to take the time out of theatre or clinic to have these discussions. And as we see increasing numbers of patients in this position, how the system can alter to value these conversations.