Global Healthcare Conversations with Mieko Perez ft. Dr. Nguyen

Dr. Vincent D. Nguyen is a Board-Certified Palliative Medicine Specialist with Board certifications in Geriatrics and Family Medicine.

He earned his Medical Degree from Western University of Health Sciences in 1992 and recently completed a 2-year CHCF Fellowship in Health Care Leadership from UC San Francisco.

He currently serves as the Palliative Care Program Medical Director at HOAG Hospital and in this role provides direct medical care as well as oversight of the inpatient and outpatient palliative clinical services.

He is a volunteer Clinical Professor at the UCI School of Medicine and also a founding member of the UCI Palliative Medicine Fellowship program for post-graduate and mid-career physicians to learn and teach the art of caring for people living with serious illness.

An eternal optimist, I went to medical school in the late 80's to help relieve people of their pain and suffering. During my early training in Family Medicine and Geriatrics, I have found myself tempted to try and fix everything but quickly learned that modern medicine can't cure old age, chronic diseases or death.

As a matter fact, chronic diseases such as COPD (Chronic Obstructive Pulmonary Disease) or CHF (Congestive Heart Failure) are creations of modern medicine that started in the 1900's with the accidental discovery of Penicillin, the introduction of mechanical ventilators for polio patients, and the development of modern diuretics for heart disease.

Many have gone through conventional treatments in the hope for a cure. These interventions of the 21st Century Medicine often are effective in buying people more time, but at times these same treatments are worse than the disease itself.

In the mid-90’s, I stumbled onto hospice and palliative medicine on an “elective” rotation in my last year of residency. I was thrilled to be working in a multidisciplinary team made up of physicians, nurses, social workers, chaplains and volunteers, which offered incredible support to patients and their families, and to each other.

The comradery and emotional benefit of processing these experiences as a cohort enabled me to discover what it means to heal in the face of no cure. From that moment on, I have been embarking on a 25-year journey as a palliative medicine specialist, called to serve as a healer and to accompany my patients living with serious illness and their family.

Physicians by nature are scientists who devote regular components of their professional effort seeking new knowledge about health, disease, or delivery of patient care through research.

When it comes to medical cannabis, most physicians are not taught and are told that marijuana is a Schedule 1 drug in the same category as heroin and cocaine with “high potential for abuse and harm.” Therefore, our patients should not be using it and should be referred to an addiction specialist.

I struggled with this concept as I have witnessed people willing to go through any lengths to have their symptoms managed and have some control of their lives.

Some even stockpile medications in case their pain increases while others turn to medical marijuana because they are not getting the careful, comprehensive treatment they need for symptom relief for a better quality of life. So, it is not surprising that they take matters into their own hands.

I am pleased to be collaborating with the Cal State University of San Marcos - Shiley Institute for Palliative Care as a subject matter expert to review a 4-week course in Cannabis in Hospice and Palliative Care to be launched later this year.

Our goal is to train physicians, nurse practitioners, physician assistants, and others caring for people with serious illnesses to better understand the clinical, legal, and ethical considerations surrounding medical cannabis to enable them to better respond and support patients and families pursuing this therapeutic option.

To simply put it, research is essential to find out which treatments work better for patients. Research plays a critical role to help us discover new treatments and help us improve our existing therapies in the most effective ways.

The field in medical cannabis is young and I would compare this to the field of Palliative Medicine when I embarked on it 25 years ago where it was taboo and touchy-feely medicine.

Now palliative medicine is a recognized medical sub-specialty with physicians spending an additional year of training to garner new skills to better care for their patients. Palliative is still misunderstood as death and dying. It is in fact a medical art of helping patients live longer and with better quality of life.

In the next 5-years, we will see an advancement of cannabis research with many medical professionals supporting the use of medical cannabis as an adjunct in their therapeutic armamentarium.

There will be much more outreach and collaboration of thought leaders in the healthcare community in collaboration with our legislators advocating the use medical cannabis as a legitimate therapy for those who desire better pain and symptom management than what they currently have.

The emerging field of medical cannabis is still a Wild West, albeit is creeping toward becoming mainstream. Work with a trusted advocate and source. I have witnessed that when a person is desperate, they get taken advantage of by whatever claims are made.

A person is never quite sure what he is buying or certain what she is ingesting. There are so many claims that are hollow without substantial back-up. Spend your money wisely and work with a trusted advocate.