Tammie E. Quest, MD, assistant professor in the Department of Emergency Medicine, Emory University School of Medicine, and former Project on Death in America Faculty Scholar, is now among three practicing, full-time emergency medicine physicians in the country, and the only physician at Grady Memorial Hospital, to be board certified in Hospice and Palliative Medicine.
Dr. Quest joins more than 1,900 physicians certified by the American Board of Hospice and Palliative Medicine since 1995.
Dr. Quest practices emergency medicine at Grady and Emory Crawford Long Hospital. She passed the rigorous board exam in February, and now hopes to establish the first-ever palliative care service at Grady for patients suffering from illnesses such as cancer, infectious diseases and advanced cardiopulmonary disease.
Hospice and Palliative Medicine is the study and treatment of patients living with life-threatening or severe advanced illness who are expected to progress toward dying, and where care is particularly focused on alleviating suffering and promoting quality of life. This medical discipline helps the patient and family face the prospect of death assured that comfort will be a priority, values and decisions will be respected, spiritual and psychological needs will be addressed, practical support will be available and opportunities will exist for growth and development.
In 2002, Dr. Quest developed an innovative curriculum teaching emergency medicine residents at Grady how to communicate the news of sudden death in the emergency room setting. It is one of the few programs of its kind in the country to use local actors as patients portraying grieving relatives, and has become an integral part of the emergency medicine curriculum at Emory. Her sights are now focused on establishing a palliative care service at Grady.
"My hope is to eventually start a consultative service for patients who are facing chronic, fatal, and life-threatening conditions, especially for earlier on in the symptom management of those diseases," Dr. Quest says. "A palliative care service basically assists medical teams and allows patients to get the most aggressive care that is appropriate for them. The doctor¹s role is to manage advanced symptoms and enhance communication regarding critical choices in the care of a patient. It empowers patients, and puts aggressive attention on quality of life by recognizing the goals of care for each individual patient."
Dr. Quest says she became particularly motivated to develop initiatives to advance palliative care practices and principles in emergency medicine when she was a Project on Death in America Faculty Scholar (2002-2004). During that period, she felt the most obvious way for her to get the experience needed was through hospice. She was drawn to hospice care, and for two years, she volunteered to work with Grady Hospice patients, 95 percent of whom were taken care of at home. She spent time in interdisciplinary team meetings with the hospice team, and providing the bedside care. This practice track allowed her to become eligible to take the palliative medicine board exam. Physicians who have completed specialty fellowship training in palliative medicine are also eligible to take the exam.
"In the course of working at Grady Hospice and seeing and caring for patients in the field, I became particularly motivated to develop more clinical competency in palliative medicine," Dr. Quest explains. "That led me to a more intense study and more academic pursuit within palliative medicine. I found that what I was studying was really quite applicable to my experience in emergency medicine."
Dr. Quest says her recent palliative boards and her work as an emergency physician are integrated; both allow her to focus on the overall care of patients.