Dr. Earnshaw joined Hosparus this spring in large part to help develop our pilot, home-based adult palliative care program. While nationally recognized today for directing the University of Louisville Palliative Medicine Fellowship program, Dr. Earnshaw almost followed another career path. She says, “I really fell into it.”
While in pre-med at St. Louis University, she volunteered at the St. Louis University Hospital. There, her volunteer duties included serving Eucharist to transplant patients. “I was troubled by what I saw in healthcare and the suffering that wasn’t being addressed,” she says.
Dr. Earnshaw left pre-med and chose a major in English thinking she would teach — another passion. But her desire to see patients treated as a whole person tugged on her. She went back to pre-med and was accepted into medical school. Her internal medicine residency brought her to Louisville. She loved working with cancer patients and in the ICU, but still felt something was missing.
“Residency training was focused on hospital-based medicine,” she says. “The philosophy was more left-brain, task-oriented — figuring out difficult diagnoses. For me, the challenge of medicine is more on how do you treat and manage patients — their emotional, spiritual, psychological well-being and how all those things impact a person’s health and wellness. All those things are magnified at the end of life.”
Halfway through her residency, her associate program director suggested she try a clinical rotation in palliative care. Dr. Earnshaw didn’t know what that was. “Here I had volunteered in a hospital, gone through medical school, was halfway through residency and yet was never introduced to palliative care.”
It was suggested she meet Dr. Joe Rotella of Hosparus. In July 2004, Dr. Earnshaw did her rotation with Dr. Rotella and the team at our inpatient unit. “I felt like I found my people.”
She discovered she and Dr. Rotella had similar backgrounds in English and the Humanities. She liked the way he really listened to patients and treated them with compassion and respect while also involving whole family. “I had never seen that anywhere else,” she adds.
After her experience with Dr. Rotella and the team at the HICC, Dr. Earnshaw decided to pursue fellowship training in palliative medicine at U of L. During her fellowship, a new opportunity arose. University of Louisville Hospital had decided to start a palliative care program. She was able to participate in the planning of the program during her fellowship, and the U of L Department of Medicine gave her the opportunity to combine her love of teaching with palliative medicine in 2006 by hiring her as an assistant professor and medical director of the new Palliative Care Program at University Hospital.
U of L was one of the first medical schools in the country to have a required palliative care clinical rotation for all medical students. Dr. Earnshaw says delivering palliative care is like hitting the pause button. It gives patients and families time to figure out what is important, then make the right healthcare decision based on their goals and values.
“You want doctors to be trained to provide an excellent diagnosis and treatment … but what if that doesn’t work? Those are the patients we are failing. Suffering is what palliative care addresses. We can do something about it. It was so gratifying being in the academic setting to teach others how to address that,” she says.
Her connection with Hosparus through Dr. Rotella led her to a position on our board of directors a little over a year ago. As she learned about our goal of launching a palliative care program beyond our traditional hospice care model, she saw another opportunity to combine her love of palliative care with her experience building new programs.
“The educational program at U of L was going and thriving. But I was seeing too many patients who weren’t hospice-eligible needing palliative care outside the hospital setting,” Dr. Earnshaw says. “Through my experience with Dr. Joe and my time on the board, I knew Hosparus has the most experience providing palliative care at home. I also like its legacy of community service and not-for-profit operating model. So, when they said they were ready to start a palliative program … I said ‘I’m in.’ This was the only place with a plan to do it. Others are just talking about it.”
We welcome Dr. Earnshaw to our growing roster of board-certified hospice and palliative care physicians, and we look forward to sharing more of her thoughts and those of other team members about the changing attitudes within the medical community and general population toward palliative care.