Pediatric Palliative and Hospice Care

I am currently the medical director of a community-based pediatric palliative and hospice care program, Community PedsCare that is the pediatric program of Community Hospice of NE Florida. Due to the success of the Community PedsCare partnership with the Wolfson Children’s Hospital, the inpatient pain and palliative care consult service was developed last year (2010) to expand pain management for medically-complex pediatric patients, especially those experiencing chronic pain due to their medical condition. I am currently the lead physician for this inpatient consult service working closely with my colleagues in anesthesiology to ensure that pediatric patients experience excellent pain control during their hospitalization.

I recently obtained board certification in hospice and palliative medicine, thereby demonstrating competencies in my role of expanding pain and palliative care services to include an outpatient component to allow for continued follow-up for patients seen during their acute hospitalization. The newly developed Pediatric Pain and Palliative Care Clinic continues to demonstrate the diverse partnerships in the greater Northeast Florida region to ensure outstanding care is delivered to pediatric patients most in need – those with chronic medical conditions with symptoms that are difficult to control – namely pain.

Pain management in the pediatric patient is a newly developing field and until recently was mainly the focus of anesthesiology. Beyond pain management in children, the focus was during the acute hospitalization with pain being one component of the treatment with little to no follow-up in the out-patient setting. General pediatricians and even subspecialists are ill-equipped to manage chronic pain in the pediatric patient – therefore, these children “fall through the cracks”.

The opportunity to attend the PAIN Week conference will enhance my pain management skills and knowledge to be able to deliver state of the art pain management to the pediatric patients in the Northeast Florida region – both in the inpatient and outpatient settings. Up till now, it has been difficult to obtain such training due to the limitations of attending pain conferences that are directed at primary physicians who care for medically-complex patients where chronic pain is only one of their presenting symptoms.

As the field of pediatric palliative and hospice medicine continues to grow and flourish, my professional goals include the development of an elective for pediatric and family medicine residents in palliative medicine to include focusing on symptom management, specifically pain management. Also, another goal is to have a fellowship in the Northeast FL region in pediatric palliative and hospice medicine no later than 2013.

I appreciate the opportunity to attend the PAIN Week conference on a scholarship to enable me to enhance my skills in pain management and bring back the knowledge obtained to provide direct patient care and enhance the quality of life of the pediatric patients experiencing chronic pain due to their medical conditions.

Respectfully Submitted,

Kelly Cronin Komatz, MD, MPH, FAAP
Board Certified Pediatrician and Hospice/Palliative Medicine