Family Medicine Residency

The goal of the inpatient Hospice rotation is to immerse the HPM fellow in the day-to-day workings of the 15-bed free-standing inpatient Hospice managed by Hospice of Central Georgia, Pine Pointe, as well as managing patients who at home on Hospice with their families. The fellow will manage patients of all ages and terminal conditions. The focus of care is on the patient and the patient's family, and the HPM fellow will join a dedicated team of nurses, social workers, chaplains, bereavement counselors, and others in providing comprehensive physical, psychological, and spiritual support of patients suffering from life-limiting illness.

Inpatient Hospice visits and home Hospice visits are also scheduled in other block rotations throughout the year, in order to offer continuity of care opportunities for the HPM fellow.

Setting:	Required PGY-4 rotation, 16 weeks (may be split into 4 and 8-week blocks)
Preceptors:	Richard J. Ackermann, MD, HPM Faculty, Rotation Director Jean Dozier, MD, HPM Faculty Laura Mullis, NP, HPM Faculty Dipesh R. Patel, MD, HPM Faculty Allison Scheetz, MD HPM Faculty
Location:	Pine Pointe Hospice of Central Georgia 6261 Peake Road Macon, Georgia 31210

The HPM fellow will evaluate and treat patients of all ages and disease conditions who are suffering from severe chronic disease or life-limiting illnesses in a hospital-based palliative care setting, including both consultation and management of a dedicated palliative care unit. Fellows will review the management of common symptoms encountered in end-of-life care, including pain (physical, psychological, and spiritual), nausea, vomiting, constipation, dyspnea, asthenia, sedation, anorexia, depression/anxiety, and delirium. Fellows will explore ethical and legal decision-making with patients who suffer from severe chronic disease and terminal illness, advance directives, the Medicare Hospice Benefit, and the impact of Hospice and palliative medicine on healthcare costs. An interdisciplinary approach to communication and grief support will be experienced.

Hospital palliative care service visits are also scheduled in other block rotations throughout the year, in order to offer continuity opportunities to the HPM fellow.

Setting:	Required PGY-4 rotation, 16 weeks (may be split into 4 and 8-week blocks)
Preceptors:	Urvi Patel, MD, HPM, Rotation Director Richard J. Ackermann, MD, HPM Faculty Florence Baralatei, MD, HPM Faculty Jean Dozier, MD, HPM Faculty Allison Scheetz, MD, HPM Faculty Jennifer Hames, PA-C, HPM Faculty Kathy A. Kemle, PA-C, HPM Faculty Amanda Lucas, MSN, HPM Faculty Laura Mullis, NP, HPM Faculty
Location:	Palliative Care Service Medical Center of Central Georgia 777 Hemlock St. Macon, GA 31201

The goal of the interventional palliative care rotation is to familiarize the fellow with cutting edge interventional management of patients with severe chronic diseases and life-limiting illnesses. Fellows rotate through the interventional radiology suite as well as the Hemlock Pain Center, an anesthesia-based service for management of complex pain syndromes. The fellows will appreciate the role of high-tech approaches to severe chronic illness, combined with an early and pervasive palliative approach to the symptom management of patients with life-limiting illness.

Setting:	Required PGY-4 rotation, 4 weeks
Preceptors:	Urvi Patel, MD, HPM Faculty, Rotation Director Anesthesiologists Interventional Radiologists
Locations:	Nexus Medical Group 770 Pine Street, Suite #L40 Macon, GA 31201 Department of Radiology, MCCG 666 Hemlock Street Macon, GA 31201

The fellow will evaluate and treat patients in a variety of long-term care settings, a Medicare Part A and Medicaid-supported nursing homes (Peake Healthcare Center and Heritage Health Care) and a private nursing home associated with a continuing care retirement community (Carlyle Place). The fellow will concentrate on comprehensive geriatric assessment and syndromes such as cognitive impairment, incontinence, polypharmacy, impaired mobility, and depression. The fellow will appreciate the comprehensive, interdisciplinary approach to institutionalized older adults, with a special emphasis on end-of- life care.

Long-term care visits are also scheduled in other block rotations throughout the year, in order to offer continuity of care opportunities to the HPM fellow.

Setting:	Required PGY-4 rotation, 4 weeks
Preceptors:	Dipesh R. Patel, MD, HPM Faculty, Rotation Director Richard J. Ackermann, MD, HPM Faculty Florence Baralatei, MD, Geriatrics Faculty Jennifer Hames, PA-C, Geriatrics Faculty Kathy A. Kemle, PA-C, Geriatrics Faculty
Locations:	The Oaks at Peake 6190 Peake Road Macon, GA 31220 Heritage Healthcare of Macon 2255 Anthony Road Macon, GA 31204 Carlyle Place 5300 Zebulon Road Macon, GA 31210

The HPM fellow will evaluate and treat patients admitted to the neonatal and pediatric intensive care units of the Children's Hospital, under the direct supervision of neonatologists and intensive care pediatricians. The HPM will not have direct patient care responsibilities for these infants and children, but rather will work as a member of the inter-disciplinary, concentrating on patients with severe chronic disease and life-limiting illnesses. The major purpose of the experience is not to fully prepare a pediatric palliative care physician, but rather to enable the HPM fellow to evaluate children facing terminal illnesses and help them and their family access appropriate palliative and Hospice services.

Setting:	Required PGY-4 rotation, 4 weeks
Preceptors:	Jean Dozier, MD, Pediatric Critical Care Physician, Rotation Director Lowell Clark, MD, Pediatric Critical Care Physician Umesh Narsinghani, MD, Pediatric Critical Care Physician Mitch Rodriguez, MD, Neonatologist Kathy Preissig, MD, Pediatric Critical Care Physician
Location:	Children's Hospital 777 Hemlock Street Macon, GA 31201