Mourning Dove Medical CEO Dr. Kaishauna Guidry, a former teacher turned hospice physician, continues to leverage her background in education to help terminally ill patients find the care they need.
Few businesses have to work as hard as hospices to dispel myths and misconceptions about their practices.
To help move the needle on awareness, Guidry, a care team physician for one of the nation’s largest hospice providers, founded Mourning Dove Medical in 2021. The mobile practice is focused on caring for patients who have been discharged alive from hospice until they once again are deemed eligible.
Guidry also recently published a book to help guide doctors who are considering a career in hospice and palliative care called “Dr. G’s H.O.S.P.I.C.E Pocket Guide: 7 Things Physicians Need to Know to be Ready to Work.” She’s also launched a podcast, “Dr. G at the Heart of Healthcare.”
Hospice News spoke with Guidry about the ways education can help overcome the challenges of marketing a hospice and the importance of care continuity for patients who have been discharged alive.
Mourning Dove MedicalWhat drew you to the hospice and palliative care field?
I actually became interested in end-of-life care in medical school. I was a non-traditional student, and I went to medical school after I was already married with three kids.
It wasn’t a dream deferred. It was actually a new inspiration. I had already graduated from UCLA with a sociology degree that continues to serve me very well, but I had to go back to school and become a scientist. That was in 2005.
In medical school, we had a course in the Humanities, and they really took the time to introduce palliative care to us and hospice care to us. It was a part of the curriculum, as was the issue of the millions of uninsured Americans.
For the first two years of medical school, I actually didn’t really understand palliative or hospice care. I thought it was withholding care. But when I was a third-year medical student on my internal medicine rotation, I had lots of patients with all chronic diseases. I learned about the trajectory of diseases, and that, coupled with the Humanities course, helped me see that I had a niche in end-of-life care.
There was a need for people to become a part of that workforce, and luckily, when I got out of residency, there was a small hospice agency that needed a physician. That’s why I wrote this book because there are people like me who are just interested in hospice but need a framework of what to do.
I’m curious as to how that learning experience may have informed your approach to educating others about hospice. You came to it with some of those same misconceptions that others have. Did that help shape your perspective?
Yes, that’s absolutely right. When I see patients, I think about the hospice conversations that I had when I was a resident — or when I have spoken with people in my personal life. I’m able to give them true, inspired words about what I learned and what I’ve seen.
Because at some point in every specialty in health care, a patient is going to die. You want to have quality health care at the end of life. Whether we’re taking care of a parent, or it’s for ourselves, all roads lead here.
How did you go about establishing your business?
While I was working for a hospice agency in southern California, there was a community-based palliative care program with about 200 patients. I was the palliative care medical director and associate hospice medical director for their four or five hospice teams.
I created an initiative when we were dealing with the [payment] cap called Pathways in Care. Everyone knows that you have patients who need to be discharged from hospice care due to an extended prognosis, and the program was a way to seamlessly get the patient the level of care that they need.
For example, a patient may be hospice-eligible, but they may come on to home health because that’s all they know about. While they were in home health, nurses would observe them declining clinically, and I would go visit them and talk to them about hospice care or talk to them about our palliative program.
Most of the time they would understand it, and we could get them into hospice care.
Also, there might be a hospice patient being discharged alive because of an extended prognosis, and maybe they have the appropriate insurance that was paying for community-based palliative care, and I could continue to be their doctor and monitor them until they decline again.
So that’s how I created Mourning Dove Medical. It was originally a mobile practice just to take care of those patients until they need hospice care again because I was interested in seeing this specific niche of people who often don’t get the care they need and end up running back and forth to the hospital.
It has expanded into other health care, consulting and things of that nature, but that’s how it originally started.
What are some of the most important things that clinicians and other fields need to learn about hospice?
I have some colleagues that meet every week. We’ve built a community since the pandemic started. One of them said that their colleagues referred to hospice as “the death squad.” People don’t need to hear that.
There’s a problem in health care in that often when doctors see their patient is dying, they see it as a reflection of the job they did. But of course, it’s not. It’s a reflection of life. If they were willing to talk about this with their patients, then they would be able to make informed decisions about their care and facilitate advanced care planning.
Because so many are not doing that, we’ve had to come up with initiatives to empower the individual so they can make informed decisions. It should start with the doctors. We should be telling them what’s going on. We know the trajectory of the disease. We should be preparing them for what’s to come, so it’s less chaotic.
I have seen so much chaos at the end, and it doesn’t have to be that way. We should be able to prepare.
What are some of the strategies that say a hospice provider can adopt to bring their message to the community and dispel some of these misconceptions?
They can do presentations at places like assisted living facilities and senior communities. They can just go out and field questions. I know that it’s hard for busy doctors to do things like that, but that’s something that we would do in some of my previous work.
Seniors were able to bring their medications and ask any questions. There was one facility that had a radio show and a television show that went into every person’s home on their internal network, and I visited there.
People have questions. They want to talk to a doctor outside of that quick 15-minute visit in a more casual atmosphere.
Unfortunately, hospice has been getting a lot of bad press lately, including in your home state of California. How do you counter those stories when you engage with families and when you engage with clinicians?
I tell them that health care is a business. Hospice is no different. When I was in my job search, I got a lot of inquiries to vet my experience and my referrals.
I would ask about their leadership, their clinical leadership. I’d ask them to tell me about their hospice care, Care Compare score, and whether anyone was going to interfere with my medical decision-making for patients because patient quality can never be compromised.
So it’s a business, but I want to empower patients to find a quality hospice with a physician who’s involved and engaged. That sets one hospice apart from another.
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