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Improving Patient Care |

The Academic Hospice

Charles F. von Gunten, MD, PhD; and True Ryndes, ANP, MPH
[+] Article, Author, and Disclosure Information

From San Diego Hospice & Palliative Care, San Diego, California.

Grant Support: By the Alfred Stengel Traveling Scholarship of the American College of Physicians, the Established Investigator Award of the National Cancer Institute K05CA102582, and the Dr. Seuss Fund (Dr. von Gunten). The work of both authors has been supported by the generosity of the late Joan Kroc.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Charles F. von Gunten, MD, PhD, 4311 Third Avenue, San Diego, CA 92103; e-mail, cvongunten@sdhospice.org.

Current Author Addresses: Dr. von Gunten and Mr. Ryndes: 4311 Third Avenue, San Diego, CA 92103.

Ann Intern Med. 2005;143(9):655-658. doi:10.7326/0003-4819-143-9-200511010-00009
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In the second half of the 20th century, medical specialties and subspecialties, new diagnostic tools, and effective therapies emerged as a result of research and unprecedented government funding. There were several cultural consequences in medical practice. Specialists achieved prominence within the medical hierarchy (1), death was more apt to follow a period of chronic illness rather than acute illness, the role of the patient radically changed (2), and an erosion of trust between physicians and their patients began to be documented (3). The emergence of hospice care in the 1960s in England, followed in the United States and Canada in the 1970s, can be seen as a reaction to these changes in medical culture.



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