New medical program to help train next generation of palliative care providers in region


ANN ARBOR, Mich. —  Helen Snow had just returned home from hiking the Appalachian mountains when she experienced sudden symptoms of a condition that would ultimately require reliance on an oxygen tank.

The onetime active pet groomer, dog show competitor, and gardener was eventually diagnosed with dermatomyositis (DM) – a rare autoimmune disease that attacks the body’s muscles – and non-specific interstitial pneumonitis. It meant overwhelming fatigue, shortness of breath and chronic pain. After three years of undergoing treatments that didn’t work, Snow is at the University of Michigan Health System’s palliative care clinic where she finds help managing symptoms to help make her life as comfortable as possible.

“This illness has completely diminished my quality of life,” says Snow, 57, of Farmington Hills, who had to quit her job and give up her home after getting sick. “When I got here, they told me ‘you don’t have to hurt. We are here to help.’”

It’s the kind of care UMHS hopes to expand with the start of a new academic Adult Palliative Medicine Program that would aim to increase the number of physicians specifically trained for palliative medicine. The program will expand clinical care, education and research opportunities related to adults with chronic debilitating disease and poise the institution as a national leader in the emerging field of palliative care.

Palliative care focuses on relieving and preventing suffering for patients at any stage of an illness and includes the management of both physical and emotional disease symptoms. Patients may be undergoing treatment for curable illnesses, living with chronic diseases or nearing the end of life. 

“The goal of palliative care is to provide relief from symptoms, and stress of a serious illness- whatever the diagnosis,” says Raymond Yung, M.D. chief of the Division of Geriatric and Palliative Medicine in the U-M Medical School.

“The new APM Program at the U-M Health System is a pivotal step in our commitment to support these patients through their disease, whether they need new pain remedies, help making difficult medical decisions or emotional guidance.”

The new program unites palliative medicine specialists, nurses, social workers and many others from across the health system and campus, focused on addressing physical, emotional, spiritual, and social concerns that arise with advanced illness. The program is expected to enhance UMHS’s existing Hospice and Palliative Medicine fellowship program, foster new research and philanthropic opportunities and help form new clinics focused on palliative care.

“Building on the expertise that exists through the health system and the schools, our new palliative care program is devoted to helping patients with serious illness live longer and more satisfying lives,” says Margaret Calarco, Ph.D., R.N., chief of nursing services.

“This new collaborative program will serve as a major hub of palliative care experts in the Ann Arbor area.”

The new structure will include representation from the Department of Internal Medicine (and several of its divisions, such as Geriatric and Palliative Medicine, Hematology/Oncology, Nephrology, General Medicine and the Hospitalist Program), the Department of Family Medicine, the School of Nursing, the School of Social Work, and the School of Pharmacy.

“We are building on over a decade of strong, interdisciplinary commitment to high quality palliative care at UMHS,” says Phillip Rodgers, M.D., assistant professor, Family Medicine. “We have seen the difference it has made in the lives of thousands of patients and families we’ve worked with in our hospitals, and a growing number in our clinics.

“Our new APM structure will allow us to strive for excellence across our missions—patient care, education and research—in the service of providing all patients and families the best care possible.” 

The palliative medicine team works together to create a comprehensive plan of care for patients. Examples of palliative care may include helping a patient recover from an illness by easing symptoms such as pain, anxiety or loss of appetite during surgery, chemotherapy or other procedures. Palliative care may also help patients transition to home after being released from a hospital or nursing facility.

“This program will allow us to train the next generation of palliative care providers,” says Adam Marks, M.D., co-director of the Palliative and Supportive Care Clinic at the East Ann Arbor Health and Geriatrics Center. “As our population ages and more people are living with chronic disease, the need for effective and timely palliative care interventions will only increase.”

There is just one palliative care provider for every 1,300 people with a serious disease, Marks notes. That compares to one cardiologist for every 71 people who experience a heart attack and one oncologist for every 145 patient with a new cancer diagnosis.

Marks started working in the palliative care clinic in 2012 after completing the Hospice and Palliative Medicine fellowship program at UMHS. UMHS also has outpatient palliative programs at Chelsea Family Medicine and the Supportive Care and Symptom Management Clinic in the Comprehensive Cancer Center.
“I saw firsthand that for some patients living with severe, life-limiting disease, the intensive care they were receiving was not the care they wanted, nor was it helpful to them in any meaningful way,” Marks says. “I also saw how palliative care providers could help advocate for those patients and families, to improve the quality of life of those living with chronic disease, and when necessary, aid in the transition to end-of-life care.  It allows me to have a profound and lasting impact on patients and their families.”

For more information on palliative care at UMHS, visit here:

For more details on the new APM structure, see our UMHS Headlines story.

See the quote board on what faculty members, leaders and community members have to say about palliative care at UMHS: