Ross Hays Oral History.

Dr. Ross Hays begins the interview by describing how he continued to pursue training after his pediatrics residency, transitioning to study birth defects, training in rehabilitation medicine, and finally training in bioethics. Dr. Hays was then recruited to become the principal investigator for a demonstration project by the Robert Wood Johnson Foundation titled Promoting Excellence in End-of-Life which finally allowed him to tie all his training experiences together. Dr. Hays then describes his observations that pain in pediatrics was recognized, but there was a lack of urgency in clinical need to treat pain -- maybe in part due to that lack of sophistication in treatment paths for pain in the early 1980s. He also recalls that psychological and social support of pediatric patients and families were not typically seen as a necessary duty to fulfill by the medical community and largely became the responsibility of the family. The differences between primary and specialty palliative care are also defined by Dr. Hays as he describes how other hospital services met his palliative team with some suspicion and anxiety of his palliative service overstepping and usurping turf. He also explains that there will always be a need for palliative care due to the progression of medicine and more complex therapies available. When someone elects to complete these more complex therapies, they create the need for palliative care along their health care journey. Dr. Hays describes the most looming challenge for palliative services to be funding, especially outside of wealthy institutions that can support a palliative service that generally is not reimbursed well. Dr. Hays also describes that the best thing about the palliative field now is the new generation of well-trained leaders that are stepping up to take the lead. The interview concludes with Dr. Hays\u27 dream of having palliative services fully integrated and automatically consulted on every case of a leukemia or complex congenital heart disease or when a child goes on ECMO. He would like to see that palliative care professionals become viewed as integral parts of the medical team