Drew Rosielle, MD FAAHPM
University of Minnesota Medical School
AAHPM reached out to the 2024 Visionaries to gain insight into what motivated them to pursue leadership positions and what they find more fulfilling in their experiences. Drew Rosielle, MD FAAHPMhas been recognized as one of the exceptional individuals chosen as a 2024 AAHPM Visionaries in Hospice and Palliative Care.
Who has most influenced your work and how have they shaped your contributions?
I did my fellowship at MCW with David Weissman who encouraged me tremendously with the Pallimed blog and introduced me to editing Fast Facts which I continue to do. I gave the chief editing role over to Sean Marks around 2015. I’ve learned a lot from Sean’s doggedly level-headed editing and leadership. Early on Christian Sinclair cold-called me about joining the Pallimed blog and I said, Sure. Best decision I ever made. Christian understood in a way I didn’t then the importance of connecting people where I was more interested in navel gazing, and, later, grumpily poking at things which annoyed me. Christian’s different way of being in the world continues to make me a better person. I wish I had more room, but here’s a very partial list of people who I am very very grateful have been there for me at one point or the other: Lisa Marr, Vicki Jackson, Diane Meier, Brynn Bowman, Lyle Fettig, Elise Carey, Molly Fettig, Sara Johnson, Gordon Wood, Holly Yang, Toby Campbell, Amy Zelinski, Jeanette Ross, Matt Tyler, Dot Landis, Karrie Lu, Elizabeth Uchitelle, Annette Nijjar, Nate Goldstein, Steve Rommelfanger, Andrew Garcia, Deb Unger, Vin Shah, Katie Neuendor, Bob Arnold, SarahScott Dietz, Porter Storey, Ryan Westhoff, Ruth Drazewski, Beth Jeffrey, Lyn Ceronsky. And, while cliched, it’s true: I continue to learn the most about how to be a decent doctor and human being from my patients, and their families, as I try to help their lives be a little better.
What is the significance to you of being recognized as a “Visionary” in Hospice and Palliative Medicine?
This is a surprisingly tough question to answer. It’s a huge honor and one I wasn’t expecting! Much of my public facing career has been very quiet work like helping to edit and publish Fast Facts and Concepts. I’m very proud of what Fast Facts are and the fact that it remains grassroots, volunteer, near-zero-budget, totally open access affair that tries to put out high quality, evidence-based, clinical teaching materials to help people better care for our patients. To this day I go to conferences and meet random people who’ll thank me for Fast Facts (although it’s Sean Marks they should really thank!). I’ll take this opportunity to thank the Palliative Care Network of Wisconsin and Mary Ann Liebert (Journal of Palliative Medicine’s publisher) for supporting Fast Fact publication over the years. My less quiet work has been the blog although the older and more exhausted I’ve become in my middle age my work there has slowed to just a drip. I mostly slowed down because I realized all I really wanted to write about were things I was grumpy about, and I didn’t want to be “that guy.” Regardless of that, I’ve used the blog in the last 10 years to try to speak, in the best way I could, about emotional and tenacious issues, and I’ve tried to do this in a way that was intellectually rigorous and honest, even if painful. It’s been gratifying to me that at least some of what I’ve written has been received well!
What is your aspiration for the evolution of hospice and Palliative Medicine?
I spent much of the last 14 years helping to build up the ambulatory palliative care practice at my organization. Overall, this has been very successful, and I’m proud of what we’ve accomplished. However, the older I get, the more acutely aware I am of the remaining huge gaps in caring for the seriously ill in my community. I see these gaps in part because patients are sent to us who have needs which our palliative care clinic just doesn’t have the capacity to address. Fundamentally, these are patients (and their exhausted caregivers) who need comprehensive, home- (including facility-) based palliative care: comprehensive services which includes active medical disease management of patients’ underlying illnesses, symptom care, psycho-social-spiritual assessment and care, practical in-home I/ADL supports, care planning, and caregiver support. Effectively, in my community, this does not exist (outside of the VA). I know there are areas of the country where these programs exist, but as far as I can tell it’s very unevenly distributed, and a lot of the programs which pop up calling themselves ‘home based palliative care’ are short-lived, and are not run by professionals who have the skills and know-how to care for the seriously ill, but instead by people whose primary interest is in next quarter’s profits. It seems we’re in this situation because nationally there’s no sane payment mechanism to provide this sort of care, and my aspiration for the coming generation of H&PC is that we collectively figure this out!
Learn more about the AAHPM 2024 Visionaries in Hospice and Palliative Care and view a full list of all current and past Visionaries.