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Training and telemedicine: the key to the palliative medicine specialist shortage?
  1. Giulio Ravoni1,
  2. Maria Fusilli1,
  3. Giulia Parretti1,
  4. Emilia Colpani1,
  5. Giampiero Porzio1,
  6. Giuseppe Spinelli1,
  7. Daniele Marinelli2 and
  8. Raffaele Giusti3
  1. 1Home Care Service, Associazione Tumori Toscana, Florence, Italy
  2. 2Department of Experimental Medicine, Sapienza - Università di Roma, Rome, Italy
  3. 3Medical Oncology Unit, Azienda Ospedaliero Universitaria Sant'Andrea, Rome, Italy
  1. Correspondence to Dr Daniele Marinelli, Department of Experimental Medicine, Sapienza - Università di Roma, Rome, 324, 00161, Italy; danielemarinelli1{at}

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American Society of Clinical Oncology and National Comprehensive Cancer Network guidelines advise that individuals diagnosed with advanced cancer should undergo early palliative care within 8 weeks of diagnosis. This recommendation stems from compelling evidence showing that simultaneous palliative care significantly improves patient symptoms, mood and overall quality of life.1 Additionally, it reduces caregiver distress and enhances the quality of end-of-life care. Unfortunately, these guidelines do not address the harsh reality that the need for palliative care far exceeds the available specialists and resources.2

Several studies have shown that the workforce of palliative care specialists is insufficient to meet the growing demands of health systems.

Projections for the future underline that this shortage of specialists will persist and worsen in the coming years.3 Recently, we analysed the Italian data, confirming this deficiency, which opens up worrying scenarios for the future.4 Different explanations can be hypothesised: burnout, lack of an academic career pathway and challenges in pursuing private practice.5

In the last two years, the Oncological Home Care Team of the Tuscany Tumor Association (ATT) has faced an acute shortage of physicians, which has endangered the continuation of the service.

The purpose of this letter is to describe the experience gained and the strategies we tried.

The ATT provides oncological home care for patients residing in the metropolitan …

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  • Contributors RG: writing - original draft. GPorzio, DM and RG: writing - review and editing. GR, MF, GParretti, EC, GPorzio, GS: resources.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.