July 30, 2004

Palliative care expert Roy Elam joins VUMC

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Roy Elam, M.D.

Palliative care expert Roy Elam joins VUMC

Roy Elam, M.D., has joined Vanderbilt University Medical Center as associate professor of Medicine, practicing in the division of General Internal Medicine.

Elam will also be working through the department of Medicine as a consultant for clinical and educational efforts in palliative care at the Medical Center.

“Dr. Elam is one of the most respected internists in this community, and he has long been interested in appropriate care at the end of life,” said John S. Sergent, M.D., professor of Medicine and vice chair for Education. “Vanderbilt already has a number of people who are involved in palliative care, but we have not had a coordinated program. I am personally very pleased that Dr. Elam has joined us, and look forward to Vanderbilt assuming a leadership role in both education and clinical practice in the area of palliative care.”

Elam was previously the medical director for a collaboration between the YMCA of Middle Tennessee and St. Thomas Hospital from 1999 to 2004. He also served as an internal medicine physician at St. Thomas and has brought his practice to Vanderbilt.

As part of his duties, Elam will assume care of internal medicine patients of W. Anderson Spickard Jr., M.D., effective Aug. 1. Spickard will no longer see patients, and instead will focus upon his work for the Physician Wellness Committee at VUMC.

“Roy Elam is one of Nashville’s most outstanding internists and a true community leader. The division of General Internal Medicine is excited to welcome him into Vanderbilt and our community of physician scholars and leaders,” said Robert Dittus, M.D., Albert and Bernard Werthan Professor of Medicine and chief of the division of Internal Medicine.

At Vanderbilt, Elam will evaluate how Vanderbilt stands in terms of its efforts in end-of-life care for inpatients and outpatients, said Allen B. Kaiser, M.D., vice chairman for clinical affairs in the department of Medicine and chief of staff of Vanderbilt University Hospital.

“Elam is a self-trained expert in palliative care,” Kaiser said. “He’ll take an inventory of what we are doing and will make recommendations to us about what we need to be doing to improve in that area.”

“We have a lot of talented people doing very good work in palliative care — perhaps they can join together,” Elam said. “I am fortunate to join others in the department of Medicine who are recognized leaders in palliative care such as Dr. Ralf Habermann, Dr. Jim Powers, Dr. Sumi Misra and John Mulder. Dr. Kim Lomis in the department of Surgery and Dr. Barbara Murphy from Oncology are among other leaders in this area.”

Palliative care includes pain and symptom management as well as quality of life improvement for patients at the end of life.

Elam said he recognizes opportunities to increase the palliative care education of medical students and house staff.

“We are delighted that Dr. Elam will be working on these important new programs in the department and medical center,” said Eric G. Neilson, M.D., Morgan Professor and chairman of the department of Medicine. “His work begins a new phase in improving our teaching and patient care in this area.”

Elam said new resident orientation now includes training on how to break bad news to patients and families, how to address “do not resuscitate” issues and how to discuss living wills and hospice referrals.

“We need to help house staff communicate to patients with advanced illnesses at the end of life and help them know when to move from curative applications to a comfort care approach,” Elam said. “Teaching medical students and residents comfort care and communication skills for patients at the end of life is important.”

“Vanderbilt is committed to providing the most effective and compassionate care possible and the palliative care program builds on and adds to that commitment,” added Dittus.

Education includes making sure residents and house staff take the time with patients to appropriately comfort them. Elam said this can begin with several efforts such as:

• sitting down to communicate with patients

• ensuring patients are as comfortable as possible when communicating with them

• communicating with patients when family members are present

• trying to understand and appreciate what is meaningful to patients and families when facing the end of life.

“We all have a lot of training and skills in curative medicine, but most of us can improve on our palliative medicine skills,” he said. “A physician’s care for patients doesn’t end when there is no longer a cure for the patient, it ends when the patient dies and grief issues have been addressed.”

Elam, a board member of Alive Hospice, has been practicing internal medicine in the Nashville community since 1976. He joined St. Thomas in 1993. While there, he worked to establish a stress reduction program and participated in the first medical ethics module which focused on medical ethics issues at the end of life. In 1991, he helped found the Centennial Medical Center’s Ethics Committee.

A graduate of the University of Tennessee School of Medicine, he completed his residency and a gastroenterology fellowship at Vanderbilt.

In May, Elam was married to Kaye White, the administrator for the Baker-Donelson law firm. He has two children, Clark and Roe, and two grandchildren, Caroline and Thomas.

“I have been very appreciative of the magnitude of kindness people have extended me in welcoming me here,” Elam said. “I am overwhelmed by what a caring community this is.”