LGFM - Fellowship Description

Hospice and Palliative Care Fellowship Description

The Hospice and Palliative Medicine Fellowship is a joint venture between the Lancaster General Department of Family and Community Medicine and Hospice of Lancaster County. It is designed to train board certified/board eligible physicians in the knowledge and skills necessary to become certified in Hospice and Palliative Medicine.

The fellowship program is a one-year program during which fellows will learn:

Management of pain and other non-pain symptoms
Communication skills, including facilitation of difficult conversations and decision making
Collaboration with interdisciplinary hospice teams and the hospital palliative care team
The psychosocial and spiritual impact of illness

Hospice of Lancaster County, established in 1980, is an independent, community-based organization that provides hospice care to nearly 500 patients and their families each day. Hospice care is provided at home, nursing home, hospital or at the Hospice Inpatient Center by a interdisciplinary team of physicians, nurses, chaplains, social workers and volunteers. The organization is a teaching hospice that provides clinical education to approximately 200 medical students, medical residents, nursing students, seminary students and social work students each year. Hospice of Lancaster County also provides grief and bereavement support to more than 5,000 adults, teens and children each month who cope with serious illness and loss. Palliative Medicine Consultants, the medical practice of Hospice of Lancaster County, offers palliative medicine consultations at home, nursing home, hospital and the Hospice Inpatient Center to complement and support other treatments that patients may be pursuing.

Curriculum/Training

Training sites include Lancaster General Hospital, Hospice of Lancaster County Inpatient Unit, continuing care retirement communities, assisted living facilities, skilled nursing homes, ambulatory care clinics and patient homes.

Core experiences: These are central to the practice of hospice and palliative medicine.

Inpatient Hospice: The 12-bed free standing Inpatient Hospice Unit at 685 Good Drive, Lancaster is the primary inpatient environment for some of the most seriously ill patients cared for by Hospice of Lancaster County. Most patients and families have multiple acute physical, emotional, social, practical, spiritual and loss issues. A second free standing inpatient unit housing 16 beds opened in October 2008. Fellows spend one block of two months and two months of one month on this rotation.
Home Hospice: Hospice of Lancaster County provides home hospice care for nearly 500 patients a day. Physicians visit patients and families dealing with complex symptoms/issues; collaborate with community physicians; serve as resources for nursing staff; and participate in weekly interdisciplinary home hospice team meetings. Fellows become integral members of their Home Hospice teams. The fellows spend one block of two months on Home Hospice rotation.
Long Term Care: Fellows’ long-term care experiences include consultations at selected extended care facilities. Special attention is given to the unique opportunities and challenges associated with providing hospice care in the long-term care environment. Additional experiences in palliative medicine visits in long-term care may be added as well. The fellows spend one block of one month on this rotation.
Palliative Medicine Consultations: This experience is comprised of inpatient consultations on the Palliative Care Service at Lancaster General Hospital and outpatient consultations through Palliative Medicine Consultants. The LGH Palliative Care Service is an interdisciplinary service consisting of physicians, nurse practitioners and chaplains. Since the spring of 2006, the service has served more than 500 patients and continues to grow. Fellows will see new consults, round on existing patients and attend Multidisciplinary Rounds in the intensive care unit. Fellows spend one block of two months and one block of one month on this rotation.

Other rotations contribute to a well-rounded fellowship experience.

Elective: Rotations are available with selected faculty specializing in radiation oncology, infectious disease, outpatient pain management and addiction medicine.
Scholarly Activity/Hospice Medical Director: During this rotation, fellows learn administrative aspects of hospice and palliative care. They may have the opportunity to attend one or more Pennsylvania Hospice Network Board of Directors meetings to learn about legislative, regulatory and advocacy issues. During this rotation, fellows participate in quality assurance and performance improvement activities at Hospice of Lancaster County. Fellows also complete their scholarly project time during this month.
Ambulatory Care: Fellows have longitudinal rotations in an outpatient oncology clinic and in an outpatient dialysis center. These experiences occur biweekly for six months. The attending oncologist has extensive experience in palliative medicine, including 10 years as a hospice medical director. The cancer center also provides a multidisciplinary team to ensure optimal care for cancer patients. The attending nephrologists provide comprehensive care for end-stage renal patients and have a multidisciplinary team to provide care for patients with this life-threatening disease.

Education Opportunities

Hospice Journal Clubs
Palliative Medicine Journal Clubs with community physicians
General Cancer Conference
GU Cancer Conference
Breast Cancer Conference
Head & Neck Cancer Conference
Chest Cancer Conference
Brain Tumor/Gamma Knife Conference
Hospice and Palliative Care Core Conferences
Ethics Committees at Hospice of Lancaster County and Lancaster General Hospital
Hospice Case Presentations
Audio Conferences from National Hospice and Palliative Care Organization and Center to Advance Palliative Care
Lancaster General Congestive Heart Failure Conference
Left Ventricular Assist Device Conference

Links

AAHPM
NHPCO
PHN
New Innovations
Fast Facts
Palliative drugs.com

Faculty

J. Andrew Probolus, MD
Dr. Probolus received his medical degree from the St. Georges University School of Medicine and completed his residency in Family Medicine at the Pitt County Memorial Hospital in Greenville, North Carolina (2005). He was The Winifred Mellano Mesa Fellow in Palliative Medicine at San Diego Hospice and Palliative Medicine Center for Palliative Studies. Dr. Probolus is board certified in Family Medicine and Hospice and Palliative Medicine. Dr. Probolus joined Hospice of Lancaster County in 2006 and has served as the Program Director for the Hospice of Lancaster County and Lancaster General Hospital Hospice and Palliative Medicine Fellowship since its inception.

Joan K. Harrold, MD, MPH, FAAHPM
Dr. Harrold is the Medical Director and Vice President, Medical Services of Hospice of Lancaster County and is board certified in Internal Medicine and Hospice and Palliative Medicine. Dr. Harrold received her medical degree from the Medical College of Virginia and completed her residency in internal medicine at North Carolina Baptist Hospital/Bowman Gray School of Medicine in Winston-Salem. During her Cancer Prevention and Control Fellowship at the National Cancer Institute, she completed a Master of Public Health degree with special emphasis in epidemiology and biostatistics.; Dr. Harrold is on the Board of Directors of the American Academy of Hospice and Palliative Medicine (AAHPM) and serves as section leader of the Physician Section of the National Council of Hospice and Palliative Professionals of the National Hospice and Palliative Care Organization (NHPCO). She is a member of the Examination Committee for Hospice and Palliative Medicine under the auspices of the American Board of Internal Medicine Hospice., She also serves as President of the Board of Directors of the Pennsylvania Hospice Network. Dr. Harrold co-authored Handbook for Mortals: Guidance for People Facing Serious Illness. She has provided numerous local, statewide and national presentations on end-of-life care, pain and symptom management, and hospice research and serves as a reviewer for books and articles on of end of life issues for medical journals and publishers.

Maria Hayes, DO
Dr. Hayes received her medical degree from Philadelphia College of Osteopathic Medicine. She completed a family practice residency at Harrisburg Hospital, Harrisburg, PA. She is board certified in Family Medicine and is pursuing Board certification in Hospice and Palliative Medicine. Prior to joining Hospice of Lancaster County, Dr. Hayes practiced Family Medicine with Hershey Medical Center. She was medical director at University Physician Group- Palmyra, and previously saw patients at University Physician Group – Elizabethtown.

D. Thais Magill, MD
Dr. Magill received her medical degree from the State University of New York Downstate Health Sciences Center in Brooklyn and completed her residency in Family Medicine at Lancaster General Hospital. She is board certified in Family Medicine with a certificate of added qualification in Hospice and Palliative Medicine. Prior to joining Hospice of Lancaster County, Dr. Magill practiced full spectrum family medicine in private practice for three years, then had a practice limited to hospital based medical pain management and palliative care for three years, both here in Lancaster.

Thomas L. Miller, MD
Dr. Miller received his medical degree from the Medical College of Ohio at Toledo, and completed his residency in Family Medicine at Lancaster General Hospital. He is board certified in Family Medicine and Hospice and Palliative Medicine. Dr. Miller served as a medical missionary in Tirane, Albania. He also served as a medical officer in Tanzania for 6 years. Prior to joining Hospice of Lancaster County, Dr. Miller worked in private practice in Family Medicine in Lancaster County.

Donald E. Playfoot, MD
Dr. Playfoot received his medical degree from Jefferson Medical College and completed his residency in Family Medicine at McKeesport Hospital in McKeesport, Pa. and Montgomery Hospital in Norristown, Pennsylvania. He is board certified in Hospice and Palliative Medicine and Family Medicine. Prior to joining Hospice of Lancaster County he worked in an underserved area as part of the United States Public Health Service and also in private practice in Family Medicine.

Thomas Gates, MD
Dr. Gates is a graduate of Williams College, Harvard Medical School and the University of Utah Family Medicine Residency. He was a partner in an eight-person rural practice in Lancaster, N.H. (1983-1991), followed by three years as a staff physician at Friends Lugula Hospital in Kenya. He completed a year of graduate studies at Earlham School of Religion in Richmond, Ind. prior to joining the faculty of Lancaster General Family and Community Medicine, Lancaster, PA. He is board certified in Hospice and Palliative Medicine and Family Medicine.

Kristi Newport MD
Dr. Newport received her medical degree from Penn State Hershey Medical School and completed her residency in internal medicine at Hershey Medical Center. She completed a fellowship in Hospice and Palliative Medicine at Virginia Commonwealth University. She joined Palliative Medicine Consultants in 2009.

Randall Oyer, MD
Dr. Oyer received his medical degree from Georgetown University School of Medicine and completed his internship and residency in internal medicine at Medical College of Pennsylvania Hospital. He completed an Oncology Fellowship at Medical College of Pennsylvania Hospital. He joined Lancaster General Hospital as Chairman of Oncology in 2006.

Rosanne Oyer, MD
Dr. Oyer received her medical degree from Georgetown University School of Medicine and completed residency in Obstetrics and Gynecology at Temple University School of Medicine. Dr. Oyer is board certified in Obstetrics and Gynecology and Hospice and Palliative Medicine. Prior to moving to Lancaster she was medical director for the Bruns House Inpatient Hospice in Alamo, California.

Michael Warren, MD
Dr. Warren received his medical degree from New York Medical College and completed residency in Family Medicine at Lancaster General Hospital. Dr. Warren is board certified in Family Medicine, Geriatric Medicine, and Hospice and Palliative Medicine. He works in private family medicine practice in Lancaster county in addition to his work with Hospice.

James Groff, DO
Dr. Groff received his medical degree from Philadelphia College of Osteopathic Medicine and completed internship and residency in Internal Medicine at Community General Osteopathic Hospital (1994). He completed a nephrology fellowship at Hershey Medical Center. He is board certified in Internal Medicine and Nephrology.

Pamela Currie MSN, CRNP
Pamela Currie received her BSN from University of Cincinnati. She received her MSN from University of Pennsylvania. Prior to joining Palliative Medicine Consultants she worked in private practice with an internal medicine practice in Lancaster County. Pam has worked as a nurse practioner in a variety of settings during her career.

Marygrace K. Lomboy, MSN, CRNP
Marygrace Lomboy received her nursing diploma from the Geisinger School of Nursing at King’s College and her BSN from Immaculata University. She received her MSN from the Family Practice Nurse Practitioner Program at Millersville University. She has received certification in family practice from the American Nurses Credentialing Center. Prior to joining Hospice of Lancaster County as an NP, she had experience as both an ICU nurse and hospice nurse. She is currently heavily involved with wound care from Hospice and Palliative Medicine patients.

Sara Wright, MSN, CRNP
Sara Wright received her nursing diploma from Memorial Hospital School of Nursing in Philadelphia. She earned her BSN from Wesley College and her MSN from the University of Pennsylvania School of Nursing. She is a gerontologic nurse practitioner with certification from the American Nurses Credentialing Center.

Coleen M. Kayden, R. Ph
Coleen Kayden graduated from the Philadelphia College of Pharmacy and is been a staff and consultant pharmacist for Williams Apothecary, Lancaster, PA. Her responsibilities include consultant work for several long-term care facilities in Lancaster County as well as Hospice of Lancaster County. She is a past chairperson of the Lancaster Community Health Plan Board of Directors; Past President of the Pennsylvania Pharmacists Association; and a member in good standing of the American Pharmacists Association, the American Society of Consultant Pharmacists and the National Community Pharmacists’ Association. She has offered numerous local, state and national presentations on pain management, non-pain symptom management, Alzheimer’s disease and dementia. Coleen currently serves as co-chair of the Pain and Palliative Care Partnership, devoted to improving pain management in long term care facilities in Lancaster County and beyond. She has chaired various committees and task forces for the Pennsylvania Pharmacists Association and currently serves as chair of the Health Policy Committee. Coleen serves on the University of Pittsburgh’s School of Pharmacy Board of Visitors; the Steering Committee for the Pennsylvania Cancer Pain Initiative, the Pennsylvania Medical Assistance Advisory Committee, the Pennsylvania Medical Society Patient Safety Forum, and, in 2005, was appointed to the board of St. Joseph’s Health Ministries in Lancaster. She is a founding Board Member of the Lancaster Pharmacists for Improved Health Outcomes (LPIHO) and serves as liaison to the Lancaster County Business Group on Health (LCBGH) and the BRiDGE Project for Patient Self-Management (PSM) in Diabetes. Currently, Coleen serves on the Steering Committee for Project Access Lancaster County (PALCO) and co-chairs the Pharmacy Committee.

We are currently accepting applications for the Hospice and Palliative Medicine Fellowship. We will begin the interview process in September for positions the following year.

For More Information Contact:
Christine Stabler MD
Lancaster General Hospital Family and Community Medicine

cmstable@LancasterGeneral.org

Phone: (717) 544-1881