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2017 Health Care Champions Top Doctor: Dr. Albert Leonardo Jr.

Mercy Clinic Palliative Care

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Palliative care is an often misunderstood and sometimes feared term in the medical community. Dr. Albert Leonardo Jr. is working to change that.

As medical director of Mercy Clinic Palliative Care, he aims to clarify the interdisciplinary field of care, which he says is growing and much needed in the Springfield area.

“As a leader of this specialty within the Mercy health system, it is an ongoing mission to teach, demystify and change the medical culture, as well as the hearts and minds of old and new medical professionals and our community,” Leonardo says.

Palliative care mostly is confused with hospice.

Leonardo points to the World Health Organization definition to clarify. There, palliative care is described as caring for those diagnosed with life-threatening illnesses by providing prevention and relief of suffering through early assessment and treatment of health issues. The problems treated could be physical, psychosocial and spiritual.

Conversely, hospice focuses on the last six months of a patient’s life in a home or homelike setting intended to maintain quality of life and to include family members in the care.

“Palliative care distinguishes itself further as a medical specialty, that it can be provided at any stage of illness,” he says, “even at time of diagnosis and most often be provided even during curative treatment.”

Leonardo knows the intimate differences having worked in hospice the last decade. He also directs Mercy Hospice, which has a daily census of 60-80 patients.

A subset of Mercy Hospice, Leonardo’s palliative care team manages such symptoms as chronic fatigue, pain and shortness of breath through spiritual care respective of one’s beliefs, ongoing communication and coordination and reviewing the patient’s goals for care. This includes advanced directives, should they become uncommunicative from the illness. Combined with traditional medical therapies, palliative care also includes emotional support throughout the process, according to clinic materials.

“That serious illness affects each individual and family differently, and treatment plans should be tailored to unique needs,” Leonardo says of the clinic’s 600-plus inpatient consults and more than 200 outpatient consults and visits each year.

While he says most palliative care programs are limited to hospitalized patients, Leonardo and company the past year have broadened their services to the ambulatory setting. The practice also has patients receiving oncology care through CoxHealth, locally, and in St. Louis, Kansas City or out of state clinics, such as MD Anderson.

In the next stage of hospice care, locally, Leonardo foresees a hospice house for terminally ill patients who can’t stay at home or a nursing home. He says the concept has been discussed but has yet to gain traction.

“Myself and other likeminded individuals in the community still believe in that dream of one day providing a hospice house for our patients locally,” Leonardo says. “Grassroots efforts are currently being explored.”

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