Medicine is about healing, but not everyone gets well. That’s where the medical specialty that addresses the needs of the terminally ill comes into play.

The American Board of Hospice and Palliative Medicine was formed in 1995 to establish and implement standards for certifying physicians practicing hospice and palliative medicine. The board works toward the development of standards that promote excellence and quality care for patients with progressive illnesses.

Thirty-three of the 1,521 American physicians who are board certified in hospice and palliative medicine live in Colorado. Seven of the 33 practice in Colorado Springs, and all seven work full or part time for Springs-based Pikes Peak Hospice and Palliative Care.

When board members at Pikes Peak Hospice hired Dr. Jonathan Weston five years ago as their full-time medical director, they were breaking new ground. Martha Barton is a registered nurse who started as a volunteer at the hospice 20 years ago. She has been the executive director and president and chief executive officer of Pikes Peak Hospice for almost 17 years. “It was a financial risk on our part to hire Jonathan, but we were ready to broaden our ability to manage a broader array of symptoms in the terminally ill,” Barton said. “We raised the bar, and it has paid off.”

Pikes Peak Hospice was the first in Colorado to have a full-time board-certified hospice and palliative medicine physician on staff and the only hospice in the Pikes Peak region employing the board-certified physicians. Innovation is what has made Pikes Peak Hospice a leader in the field since its inception 24 years ago. From 15 patients per day, 20 employees and 50 volunteers in 1980 to a $15-million operation with 200 patients, 275 employees and 400 plus volunteers in 2004, the Springs hospice has built a strong reputation because of what Barton refers to as “a bigger landscape for end-of-life care.”

That bigger landscape includes a holistic approach to terminal illness that includes teams of chaplains, physicians, social workers, certified nurse assistants, counselors, registered nurses and volunteers. Teams manage individualized care plans, which include therapies such as music, art, pets and massage.

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Pikes Peak Hospice leases space at St. Francis Hospital for an inpatient program that is modeled throughout the country. When Denver hosted the annual assembly for the National Hospice and Palliative Care Organization last year, Pikes Peak Hospice was chosen as an onsite convention visit because of its inpatient facility.

Weston is board certified in hospice and palliative medicine. He manages four full-time board-certified staff physicians and three part-time board certified physicians. Most of the doctors have backgrounds in other modalities of medicine, such as family practice. The newest hire is Dr. Cynthia Moffet, whom Weston said exemplifies the next generation of doctors certified in the field. Moffet joined the Pikes Peak Hospice team in August 2003 after completing a fellowship with San Diego Hospice. She will oversee the many home-based patients under the care of Pikes Peak Hospice.

“Our focus is not on disease but on the terminally ill patient,” Weston said. “We (doctors) are trained to prolong life, but sometimes we are prolonging death. We try to afford them (terminally ill) a quality end of life they normally wouldn’t have. It’s a tough road, where communication and planning is very important. At least now the patient has choices, and they don’t have to play by the rules of traditional medicine.”

Hospice patients are at home, in the hospice inpatient program or in long-term care facilities. Hospice doctors make regular house calls. They also consult for other physicians who have terminally ill patients unassociated with a hospice.

Weston said hospice doctors are on equal ground with all the members of the team. “We are no more important than the rest of the disciplines,” Weston said.

As people desire more choices when facing the end of life, the doctors who specialize and understand the bigger landscape will be more in demand, Weston said. “I was recently in Phoenix, Ariz., and hospice and board certified physicians were bulleted in 10 hospice ads in the Yellow Pages,” Weston said. “Although the field is new, Colorado Springs is setting the trend statewide and nationally.”