The criteria for the awards have been established by The Hastings Center Cunniff-Dixon Foundation Selection Committees, which was convened specifically for this purpose.
- Please note the additional criteria added at the end for the new Dr Richard Payne Leadership Award
1. Technical Competence
Competence is a baseline requirement. It encompasses both technical knowledge of the best means of care as well as skill in determining how best to deploy care with individual patients. The ‘art’ and science of medicine comes into play.
2. Personal Integrity
Personal integrity means that combination of personality traits and virtues most conducive to good end-of-life care. Humility is a key virtue. That means knowing what one does not know, a willingness to shift modes of treatment when an earlier course proves inefficacious, and a sharing of uncertainty with colleagues.
Friendship with patients, though not always possible, is an advantage. Dying can be lonely, and often only the clinician is in a position to be a steadfast companion. Availability is hardly less important, but it requires openness to inconvenience and schedule disruption. A willingness to make house calls to avoid unnecessary visits to hospitals or physician offices is an important mark of availability. Most fundamentally, patients need to know they will not be abandoned. Come what may, the clinician must be there until the very end.
3. Physician-Patient dialogue
As far as possible, a dying person should be actively engaged in his or her care. Minimally, this means understanding the likely nature, course, and trajectory of treatment. The physician should let the patient know what to expect and what is being done to help. The physician should also seek the patient’s informed involvement in decision-making. A physician’s first task should be to assess the patient to gain a sense of what to say and not say – that is, what kind of a dialogue it is likely to be, and how to change it if it is initially not promising. Dialogue involves more than just communicating information; it is as much about listening.
4. Active engagement of friends and family
Most patients have family and friends, and how a patient fares will be affected by their relationship with them. The family needs its own assessment and dialogue initiated. While a physician may not be well placed to help resolve all problems or tensions between patients and families, it is useful to be aware of them.
5. Ability to function well as part of a care team
Few physician’s work alone and, especially with end-of-life care, cooperation among caregivers is crucial. There will be different people providing different kinds of care, so coordination and full engagement among them is important. This is particularly so with regard to nurses and nursing assistants. Often, nurses have the greatest knowledge of the patient’s day to day experience and family concerns. This is true in all settings, and especially in home care. Continuity of care is especially important, and the principal clinician caring for the patient has a special responsibility to make certain the patient knows who is in charge and that his or her personal physician will be there when needed. For all these reasons, the ability to work well with a team is an important ingredient of good care.
- There are two additional sections of criteria if you are nominating a physician for the Dr Richard Payne Leadership Award. This award is intended to honor physicians who are committed to work in palliative care with vulnerable and/or underserved populations. Additional criteria includes:
- Details about community served
- Vulnerable populations, including the economically disadvantaged, racial and ethnic minorities, LGBTQ people, people experiencing homelessness, rural populations, refugees, immigrants and closed populations such as prisons often do not have access to quality palliative care. Please describe the population that your nominee is serving, the roles they have taken on and how long they have been serving this community.
- Leadership in serving vulnerable populations is crucial in creating the quality and access to care that all human beings need and deserve. Such leaders also serve as important role models and mentors that will attract quality and motivated clinicians to this important work. Please address the nominee’s skills, virtues, behaviors and commitments that have helped provide quality palliative care to this population and/or policy changes resulting from the leadership intervention.
- Details about community served