21 Years of Palliative Care at UVA Health

School of Medicine Associate Professor Leslie Blackhall, M.D. is the section head for the University of Virginia's Palliative Care Center. What began twenty-one years ago with three caregivers has grown to a synergistic team of more than one dozen caregivers who collaborate with various UVA medical departments to provide care. Over the past two decades, countless patients, families, and friends have received compassionate, purposeful, and expert health care at UVA's Palliative Care Center. 

The University of Virginia Palliative Care service started in the late 1990s, as an in-patient consultation service with one physician and two nurses, seeing patients with serious illnesses such as cancer or heart failure. These patients needed help with pain and other symptoms as well as guidance in making decisions about care at the end of life.

In the past 21 years, we have grown from that small consultative program to a service that includes 6 physicians, 3 NPs, 4 RNs, and a social worker. I was recruited to this program from the University of Southern California in 2001 and that year I started the Palliative Care clinic which is embedded in the UVA Cancer Center (now the Emily Couric Clinical Cancer Center).  The palliative care clinic, which started with one doctor ½ day per week, now has 3 physicians and an NP and sees patients 5 days per week with after-hours coverage. 

Although people are sometimes afraid of the implications of a palliative care referral, our inpatient and outpatient teams see patients at all stages of their illnesses including cancer patients receiving curative treatments, and cancer survivors who are still having symptoms related to cancer treatments. We work side by side with oncology, cardiology, neurology, and other teams to provide state-of-the-art treatments for symptoms like pain, nausea, anxiety, and fatigue. Studies, including those conducted here at UVA, have shown that cancer patients who receive this kind of concurrent care (with palliative care and oncology working together) have a better quality of life, are admitted to the hospital less, and may also live longer. In 2012, we partnered with Dr. Paul Read of radiation oncology and received the Centers for Medicare and Medicaid Services Innovation Award (CMS) to develop a process for early integration of palliative care services into the care of those with advanced cancer. We have been recognized as a national Palliative Care Leadership Center by the Center for the Advancement of Palliative Care (CAPC) and provide training to other institutions hoping to start or expand community-based palliative care services. 

We love our work.

Sometimes we work with patients who just want to spend the rest of their lives at home, and we help to make that possible. Often we help patients whose quality of life has been affected. When someone who has been unable to get out of bed due to cancer-related pain walks into the palliative care clinic telling us that they were able to play with their children for the first time in months because their pain was well controlled, or is sitting up eating breakfast after being admitted for uncontrollable nausea, it makes our day.  We love being part of the care teams at UVA which make such a difference in people’s lives.