So I'm rounding the other day when I happen to stumble across an advanced cardiac life support (ACLS) manual, that is given out by the American Heart Association, sitting aimlessly at one of the nursing stations. I just completed my ACLS recertification this month with a remarkable 84% on the test. I say remarkable because the ACLS nurse certifiers tell me that means 84 out of 100 patients I perform CPR on will survive.
If only I had answered intraosseous instead of intravenous as the preferred medication route of access during a code, five out of one hundred more of my patients would survive with my CPR skills. Apparently, 99.9999% of all hospitals performing CPR are killing their patients by not providing intraosseous access, as the answer to the test question says so.
With that said, I was surprised to see the name of the physician on the ACLS packet hanging out at the nursing station. It was none other than the phenomenal palliative care physician I have the honor to work with on a daily basis.
I thought that was a bit odd. A palliative care doctor recertifying for ACLS? Perhaps there was a new branch of palliative ACLS I wasn't aware off. Maybe it was PACLS, or palliative advanced cardiace life support, where talk therapy and communication replaces chest compressions and all that nonsense.
Everyone knows that patients prefer talking and communication over quality and good outcomes. That's a fact. Having a branch of palliative advanced cardiac life support just makes sense in an ObamaCare world where cost is everything and quality is defined by patient satisfaction scores. Perception trumps reality. That's the world we now find ourselves practicing in. And that perception equals money. If you want to get paid, you're going to have to play the game the best in order to beat the rest.
As for this up and coming branch of critical palliative care, I see her leading the charge for the new specialized subspecialty of palliative advanced cardiac life support, complete with its own set of invented billable CPT procedure codes, rammed through the RUC and the AMA with reckless abandonment. Forget everything you've learned about ACLS in the past. It's not about CPT® 92950 . It's not about Code Gold. It's not even about hospitalist vs palliative care in the ICU.
It's about making the patient feel good, even when they lack a beating heart. Heck, it even gives you an opportunity to bill critical care on a dead person. The time has come for all hospitalists to take the initiative and learn palliative advanced cardiac life support. Because our patients deserve it. More on that soon...
