By Melanie Marshall
Longtime Bay Area physician Robert A. Mueller, MD, MBA, MPH, FACEP, has for years combined his love of learning with his passion for palliative medicine, building a personal library of more than 240 books and digital recordings on everything from end of life care to Reiki healing touch to “The Lost Art of Listening.”
Now retired, Dr. Mueller has gifted his collection to the California State University Shiley Institute for Palliative Care, where it will be used for ongoing staff and curriculum development. Since 2012, the Institute has trained more than 16,000 current and future health care professionals across the country, using a groundbreaking online educational model that emphasizes whole-person, patient-centered care aimed at improving quality of life for people with serious or life-limiting illness.
Treating the Whole Person
Dr. Mueller entered palliative medicine after spending 36 years as an Emergency Medicine physician in teaching and community hospitals in San Francisco and surrounding communities. Over time, he said, working in the ER began to feel like “stopwatch care,” where doctors were expected to move quickly from patient to patient, focusing only on symptoms instead of the people experiencing them. He felt called to do more.
“I wanted to be where I could truly connect with patients as human beings,” Dr. Mueller said in a recent discussion with Institute staff. “People are complex in so many different ways, yet we share this common experience – we’re all going to die. I wanted to be there with them and support them through that process.”
Prior to his formal palliative medicine training, Dr. Mueller served as a hospice volunteer and also participated in the End-of-Life Care Practitioner Program at the Metta Institute in Sausolito, CA. He completed his Palliative Medicine Fellowship at the University of Washington School of Medicine in 2012.
Challenges in Expanding Palliative Care
Dr. Mueller said although it’s been gratifying to see awareness and interest in palliative care growing over the past several years, several hurdles remain in making it accessible to patients on a broad scale. He cited an ongoing shortage of palliative care specialists, the need to get the word out to physicians and the community about the benefits of palliative care, and the need to get clinicians, patients and families more comfortable talking about end of life issues.
The formal referral process can also be a barrier, Dr. Mueller said, and can prevent patients from getting concurrent supportive care until the primary physician and treating specialist determine that curative treatment options are exhausted. Non-palliative specialists may need education on how and why palliative care should be offered early in the course of a life-limiting illness, alongside curative treatment, so that patients and families can benefit from its full effect.
The Beauty of Patient-Centered Care
Ultimately, Dr. Mueller said, the power of palliative care and hospice care is supporting patients and families in highly personalized ways that focus on their own values and what brings them joy. He said he’s already thought about the kind of care he’ll want when he approaches the end of life, right down to the music playing in the background.
“No Frank Sinatra – I want Jimmy Hendrix,” he said with a smile.