September 18, 2003
End-of-life specialist heads east
By GINNY MERRIAM of the Missoulian
Ira Byock accepts Dartmouth position
Missoula physician Ira Byock, a national leader in advocating active, compassionate care for dying patients, has accepted a new job at Dartmouth Medical School.
Byock will begin in early December as director of palliative medicine at Dartmouth Hitchcock Medical Center in Lebanon, N.H. He will still participate in ongoing research in issues surrounding death and dying in Missoula at Life's End Institute: Missoula Demonstration Project, which he and Barbara Spring founded in 1996.
"I love Missoula," Byock said in an interview Wednesday. "And, frankly, it doesn't feel emotionally like we're leaving here."
However, he said, "I was recruited by Dartmouth, and it was too good to turn down."
The mix of duties he will have at Dartmouth greatly attracted him, Byock said. As director of palliative care, he will get some clinical time with patients. He will also teach medical students and fellows and work closely with them in their education about end-of-life care and challenges. The job will also have a strong research component, in clinical settings and in the larger arenas of community and health care policy.
Among the nation's academic medical centers, Dartmouth is one of the most focused on care of the whole patient, he said. It is also committed to integrating palliative medicine - compassionate care at the end of life - with mainstream medicine.
Dartmouth Hitchcock is a Level 1 trauma center - the most comprehensive - and one of the 32 top cancer treatment centers in the country.
"And yet it has the tradition of working with patients and families," he said.
Byock and Spring's Life's End Institute, founded as the Missoula Demonstration Project, has made Missoula a national model for quality care that involves the whole community at the end of life. Their early research found that while most people want to die at home, most don't. Most people don't want to experience pain, but most do. In Missoula, the result of that knowledge has been such projects as the development of a pain scale so people can better communicate with their health care providers and suffer less.
"It requires more than excellent medical care," he said. "It requires a response from the community."
That has caught on around the country, and the area around Dartmouth is rich with possibility for that work, Byock said.
"The value that our work represents has been recognized," he said. "And it's exciting to think of replicating our work in a new community."
Byock's wife, Yvonne Corbeil, who was assistant director of McGill University's palliative medicine program before moving to Missoula and working with Byock, will work for Dartmouth Medical Center's Section of Palliative Medicine. She will work in program development, assessing and drawing together all the hospice resources in the area under the Dartmouth umbrella.
"We'll just have to explore what the possibilities are there," she said.
Byock will continue to be a national and international spokesman for quality care at the end of life, which will continue to benefit the Life's End Institute, said co-founder and gerontologist Spring, who works as its community liaison.
"We all love him and love his vision and are always excited to convey to the rest of the country what we're doing," Spring said.
"We're here doing it, and he's out there talking about it," she said. "We are the feet who put it into action."
Byock will continue to direct the Robert Wood Johnson Foundation's national grant and technical assistance program, Promoting Excellence in End-of-Life Care, based at the University of Montana, for the remaining year and a half of its grant.
Life's End Institute is directed by Sally Mullen.
Byock, who's 51, has worked in hospice and palliative care since 1978. He helped found a hospice home care program for indigent people in Fresno, Calif. He came to Missoula in 1987 to work as an emergency room doctor at Community Medical Center and as medical director for Partners Hospice and Palliative Care Services. He worked at both those jobs for 10 years.
Byock and Corbeil will keep their house in Missoula and plan to return at retirement.
"I'm excited," Byock said. "It's going to be an honor to be doing it. It's a new challenge."
Copyright © Missoulian