Meet Dr. Salli Whisman, the last, but certainly not least, in our series on our pioneers. One could even argue that she is the MOST important, and we will tell you why later in this feature. As the Senior Hospice Medical Director for Bluegrass Care Navigators since returning to Lexington in 2005, Dr. Whisman was the first physician hired at the agency dedicated to the care of home hospice patients.
“Medical director services were primarily volunteer at that time, and my role was to support those volunteers (physicians) while meeting the need for more physician involvement in the day-to-day needs of our patients and staff,” Whisman said. “The level of acuity of patients was changing such that patients were admitted much later in their illnesses, much sicker and in need of a higher level of physician involvement to meet their needs at home.”
Since her hiring, the nonprofit’s department of medicine has grown to include seven hospice team physicians in addition to Whisman.
One of Dr. Whisman’s proudest accomplishments has been to give seriously ill patients more of a voice in their care. To that end, she led a legislative initiative to bring the Medical Orders for Scope of Treatment (MOST) form to Kentucky residents in 2015.
“Bluegrass Care Navigators has been instrumental in looking for ways to provide end-of-life care for patients and their families that is consistent with their goals of care,” Whisman explained. “Patients facing serious illness generally need to have a voice in what their care is going to look like, and often lose that voice within the aggressive, busy and difficult-to-understand healthcare system.
“BCN has found many ways to give patients that voice, but one very significant one is in support of MOST. MOST is a medical order to accompany and interpret an individual’s desires for medical care and/or advance directives. MOST addresses significant issues such as resuscitation and hospitalization, but also addresses routine healthcare decisions that become very important for the patient with advanced or serious illness.”
The goal of MOST is to make sure that informed patient preferences equate with care received. Bluegrass Care Navigators, along with the Kentucky Association of Hospice and Palliative Care (KAHPC), worked with the Kentucky legislature to make MOST a reality in Kentucky.
A Lexington native, Dr. Whisman graduated from the University of Kentucky with an undergraduate degree in human studies and her doctorate in medicine. A family practice residency at the Mountain Area Health Education Center took her to Asheville, N.C., where she worked in a variety of positions from 1995 to 2005. Her last position before returning to Kentucky was as Medical Director of CarePartners Mountain Area Hospice and Palliative Center in Asheville.
“The basic tenants of hospice and palliative care – to provide excellent, holistic care to patients and their family when facing serious illness – has not changed," Whisman says. "How and to whom we provide that care has changed dramatically since the early years and certainly in the last 20 years that I have been involved. We have moved from the fringes into the mainstream of medicine, which is powerful. Hospice and Palliative Medicine (HPM) is now a recognized sub-specialty with fellowship training, board recognition, and certification.”
“Our national agency is extremely active in shaping the opportunities for hospice and palliative medicine across the healthcare spectrum,” Whisman continued. “Evidence-based medicine, research, and quality initiatives and mandates are all having an increased role and impact on how, when and for whom HPM is provided and utilized. The for-profit industry has entered and shaped the world of hospice and palliative medicine, and the Affordable Care Act has improved access, mandated quality, and encouraged system-wide collaboration that includes HPM services. Leadership has positioned the agency well to utilize these national trends to increase our support and widen the impact of our mission. I feel like I have been able to be a part of that in some small measure and for that feel very satisfied.”
In addition to her role as Senior Hospice Medical Director, Dr. Whisman also serves as associate director of the University of Kentucky/Bluegrass Care Navigators Hospice and Palliative Care Fellowship and a volunteer faculty member at UK.
“I feel that [BCN] is strong and well-positioned to meet the needs of a widening population of elderly, frail, seriously ill and debilitated persons,” Whisman concluded. “These are the patients that my heart leads me to. This is the population that I feel most often falls into a void in healthcare, and I’m humbled to be able to be invited into their lives. This agency allows me that opportunity and its growth means increased and improved opportunities will continue to develop.”