Turning toward dissonance: lessons from art, music, and literature.

Conflict and chaos are prevalent in health care, and perhaps especially in palliative care. Typically, our point of entry into our patients' lives is often at the moment of conflict, discord, or intense suffering. Despite this, little in our formal training as clinicians teaches us how to be present for this suffering. Much has been written about the process of communication with regard to giving bad news, handling family meeting conflicts, and negotiating shifting goals of care, but little has been addressed about how to train the clinician to be present with the dissonance and suffering. In this paper, we explore how music, art, and literature teach us how to stay in moments of tension. In turn, lessons on how to learn to lean into the dissonance of many palliative care encounters are extrapolated.

Assessing local market and organizational readiness for the integration of complementary and alternative medicine into ambulatory care centers.

Complementary and alternative medicine (CAM) is one of the fastest growing segments of the health care industry today, with studies suggesting that between 30% and 50% of the adult population in the United States uses some form of CAM. Many ambulatory care centers are considering integrating CAM into their clinical services. This article will review some of the national trends and present a framework for assessing local market demand for CAM in order to help prioritize an organization's CAM integration strategy.