Our History
PSHPM and the Specialty of Hospice and Palliative Medicine
Supportive Hospice & Palliative Care (SHPC) - also known as "hospice & palliative care" or simply "palliative care" - refers to the clinical practice, while Supportive Hospice & Palliative Medicine (SHPM) - also known as "hospice & palliative medicine" or simply "palliative medicine" - refers to the specialty field. The goal of care is to prevent and relieve suffering and to support the best possible quality of life for patients and their families, regardless of the stage of the disease or the need for other therapies. Hospice and Palliative Medicine has been a recognized medical specialty field for the past 20-30 years.
The specialty field has been in the country since the creation of the country's first specialist fellowship training and service program at the UP-PGH in 2001. It is already a well-established, and widely recognized specialty field - locally and internationally. The Center for SHPM at the UP-PGH serves as the National Academic Center of the medical specialty field in the Philippines. In the absence of an actual national specialty organization, it currently serves as the representative of the community of Hospice and Palliative Medicine specialists in the country. It is also the main supporter of the proposed Philippine Society of Hospice and Palliative Medicine.
Our Journey
Early History
The First Phase
As in other countries, hospice and palliative care in the Philippines first began with various types of supportive and hospice care programs for patients with debilitating, advanced and/or life limiting illness. The concept of a distinct medical field of medical field of SHPM in the Philippines can be traced back to Dr Josefina Magno - a Filipino Oncologist who was one of the pioneers of the hospice movement in the States, and one of the founders of the American Academy of Hospice and Palliative Medicine in 1988. After the difficult task of organizing the early hospice and palliative care physician providers from various medical fields, Dr Magno returned to the Philippines and began to strengthen the hospice care movement in the country. Unfortunately, the Philippines already lagged behind in the development of hospice and palliative care and there was not enough dedicated physician providers to organize and establish the medical specialty field.
After a period of early enthusiasm and growth, the early hospice care movement in the Philippines suffered from dwindling support from government and private institutions. Many programs which were dependent on the support of government and other charitable institutions closed due to lack of funding, while many of those which remained failed to significantly expand and upgrade their services to meet international standards. Programs in private hospitals either closed due to poor hospital support and low income generation, or were transformed into less than appropriate hospice care programs were services were limited in order to allow the care program to generate some immediate financial returns for physicians and institutions.
Early History
The Second Phase
The second phase of the early history began with the creation of a hospice care program from a home care program at the country's national academic center for the health sciences, the University of the Philippines - Philippine General Hospital (UP-PGH) - mainly through the efforts of Dr. Catherine Krings, a Family and Community Medicine specialist; and the subsequent creation of the country's first first post-residency training program for hospice and palliative care. Initial work focused mainly on creating a firm foundation within the UP-PGH, and in developing the basic academic training and service programs. This was followed by the rapid transformation and expansion of the UP-PGH program into an internationally recognized national academic center for the field of hospice and palliative medicine in the Philippines. This exponential development and expansion of the PGH Program, allowed the program to train several specialists per year.
The early history of the field is expected to end with the creation of an actual community of palliative care physicians; and the creation of other specialist training programs by SHPM trained specialists. Unfortunately, the difficult task of creating a formal society by bringing together various personalities and physicians with varying ideas and interests, is still ongoing in the Philippines. While waiting for a workable consensus, a uniquely structured SHPM Network was devised to create a system and culture of communication, cooperation, resource sharing and systems integration. Furthermore, the unique SHPM Network set-up does away with any leadership positions or privileged positions, prohibits politicking and bickering within the network, and limits non-academic and social concerns in order to maintain its focus on academic and service program development in the Philippines.
Brief History of the UP-PGH SHPM Program
The Supportive, Hospice and Palliative Care Program at the UP-PGH had its beginnings in 1953 as the “home care and social service arm” of the Philippine General Hospital (the country's largest tertiary government hospital, and it's National University Hospital).
It became a departmental program when the Department of Family and Community Medicine was created in 1975. The holistic and humane philosophy of hospice and palliative care was easily embraced by the department when it started the Family Health Care Program (FHCP) in 1991. The main venues were the home and out-patient clinics. The services offered by the program focused not only on pain and symptom control but also on the psychosocial aspect with the help of the biopsychosocial framework.
In 1997, an in-patient Hospice Unit was created in the Cancer Institute of the Philippine General Hospital. This strengthened the consultancy and referral service of the program: inter-hospital and university coordination was made between SPHC and various departments in the UP-PGH system; and strong network alliances were created with other hospice care providers within in Manila and the rest of the country.
In 2002, a fellowship training program for hospice and palliative care was created. The Program was then renamed Supportive, Palliative and Hospice Care (SPHC) the following year. From 2007-2010, the fellowship training program was progressively upgraded based on international guidelines to meet the increasing needs of tertiary care institutions in the country. In 2010, the specialty field, the Center, and the specialist (fellowship) training program were renamed Supportive Palliative and Hospice Medicine (SPHM).
In 2011, the name was further modified to Supportive Hospice and Palliative Medicine (SHPM) to make it more congruent with the familiar international designation of the discipline. The word "Supportive" was retained to reflect the significant emphasis of the Philippine model on a specialist practice with a wide range of psychosocially oriented supportive care competencies and services. Such a model and its relatively demanding specialist training program is needed in low-middle income countries (like the Philippines) which cannot financially sustain the kind of multidisciplinary teams which play a significant role in the models of hospice and palliative care in developed countries.
Since its creation, the SHPM at the UP-PGH, as well as the growing network which it supports, have taken on the responsibility of advancing the specialty field of supportive, hospice and palliative medicine in the Philippines. SHPM at the UP-PGH is the largest and most comprehensive service and academic institution for SHPM in the country. The SHPM maintains and supports the largest network of trained and certified supportive hospice and palliative medicine (tertiary level) specialists and physician providers of primary and secondary level hospice and/or palliative care in the country.
Our New Identity
This is a sample explanation of the logo from Asia Pacific Palliative Care Network. Use this as reference but do not copy.
A stalk and a head of green rice grains bent into a circle.
Rice is the staple grain in the region. There are many grains coming from this one green stalk, just as there are many hospice and palliative care programs emerging in Asia and the Pacific.
The grains are green rather than gold. This is the colour of vitality and growth. But in the future the grains will ripen to become seed for new growth and development.
The circle represents the cycle of life. The circle is broken just as the lives of our palliative care patients are broken.