Haider Warraich
speaker
683 appearances
3 recordings
1 series
first heard Oct 2020
last heard Dec 2021
Haider Warraich’s voice in public audio — every appearance, attributed to the second.
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Whenever I introduce myself and I tell people that, oh, I'm interested in heart failure, at the intersection of heart failure and palliative care, many people say, oh, that's a great niche.
And I say, no, this is actually most of what we do.
And I think, first of all, I try and sensitize people to the fact that this is a big part of our jobs.
And that if you are going to be a good cardiologist, if you want to take pride in yourself as a good cardiologist or heart failure doctor, this has to be a really central part of what you do.
And really, some of the best...
primary palliative care I've seen is delivered by advanced heart failure doctors, even though they may not necessarily think of themselves as that this is the main part of what they do.
So I think part of how I introduce this is by
removing this notion that palliative care is only for a subset of patients who are essentially at the end of life or within the last few days or weeks of life, but really trying to extend that to really a large proportion of the patients that we see in the work that we do.
I would have to agree with you.
And it may not just be hospice, but how we use it.
But certainly...
The way I think about this is that if we keep using prognosis, for example, as an entry point to hospice, if the whole idea of hospice is that, oh, when you can confidently say that someone has limited prognosis, then you enter into hospice, I would think that that will not work.
The other issue with hospice is that I think hospice works if you have some type of outlet for
exacerbation.
So if you have a model in which you can allow concurrent therapy, so if you can allow provision of IV diuresis or some type of intermittent escalation so that you can stabilize patients and keep them there, I think it's a model that will work better.
I think this idea that once you go to hospice and, oh, if you need... Then if you sort of
have a heart failure exacerbation, you either have to continue in hospice and do the best you can with whatever options you have, or you have to essentially
you know, disenrolled from hospice, come back to the hospital.
And we see a ton of that.
I see a ton of patients.
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