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Peer-reviewedCC BY-NC 4.0Cancer Control: Journal of the Moffitt Cancer Center

Communication as a Clinical Intervention: The Role of the Oncology Hospitalist in Primary Palliative Care

  • Rahul Mittal1
  • Augustus Chang2
  • Ameish Govindarajan3
  • Biren Saraiya2
  • Jonathan Briganti2,4,5
5 affiliations
  1. 1Department of Health Informatics, Rutgers School of Health Professions, Piscataway, NJ, USA
  2. 2Division of Medical Oncology, Rutgers Cancer Institute, New Brunswick, NJ, USA
  3. 3Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
  4. 4Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
  5. 5Palliative Medicine and Supportive Care Program, Robert Wood Johnson University Hospital and Rutgers Cancer Institute, New Brunswick, NJ, USA
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Abstract

Introduction: Hospitalized patients with advanced cancer frequently experience high symptom burden, prognostic uncertainty, and complex decision-making needs. Although specialty palliative care improves patient-centered outcomes, access remains limited in many inpatient settings. Oncology hospitalists may be uniquely positioned to deliver elements of primary palliative care during acute hospitalizations. Communication is a core clinical skill in hospital medicine, yet many oncology hospitalists feel underprepared for breaking bad news, discussing prognosis and leading goals-of-care conversations. As providers of primary palliative care, oncology hospitalists help patients and families understand serious illness, explore personal values, and make decisions that align with what matters most to them. However, despite engaging in these conversations routinely, communication training and educational resources specifically tailored to the oncology hospitalist role remain limited.

Methods: Drawing on published literature and established communication frameworks, this narrative review examines the role of oncology hospitalists in delivering primary palliative care communication. Evidence-based frameworks, including SPIKES, NURSE, and Ask–Tell–Ask, are illustrated through representative inpatient oncology case vignettes.

Results: Oncology hospitalists are often the clinicians most consistently present during hospitalization and are therefore well positioned to initiate and revisit goals-of-care discussions, clarify prognosis, and align treatment decisions with patient values. Integrating structured communication approaches into inpatient oncology practice may enhance patient understanding, promote goal-concordant care, and reduce fragmentation. Successful implementation requires formal training, institutional support, and clear role delineation alongside specialty palliative services.

Conclusion: Embedding primary palliative care competencies within the oncology hospitalist model represents a scalable strategy to strengthen inpatient cancer care delivery. As oncology hospitalist programs continue to expand, integrating structured complementary, well-established, frameworks into routine inpatient practice may improve patient-centered care and promote goal-concordant treatment decisions.

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Cite

BibTeXRIS
BibTeX
@article{mittal2026communication,
  title = {{Communication as a Clinical Intervention: The Role of the Oncology Hospitalist in Primary Palliative Care}},
  author = {Rahul Mittal and Augustus Chang and Ameish Govindarajan and Biren Saraiya and Jonathan Briganti},
  journal = {Cancer Control: Journal of the Moffitt Cancer Center},
  year = {2026},
  month = sep,
  doi = {10.1177/10732748261491715},
  url = {https://doi.org/10.1177/10732748261491715},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Communication as a Clinical Intervention: The Role of the Oncology Hospitalist in Primary Palliative Care
AU  - Rahul Mittal
AU  - Augustus Chang
AU  - Ameish Govindarajan
AU  - Biren Saraiya
AU  - Jonathan Briganti
PY  - 2026
DA  - 2026/09/29
JO  - Cancer Control: Journal of the Moffitt Cancer Center
DO  - 10.1177/10732748261491715
UR  - https://doi.org/10.1177/10732748261491715
AB  - Introduction: Hospitalized patients with advanced cancer frequently experience high symptom burden, prognostic uncertainty, and complex decision-making needs. Although specialty palliative care improves patient-centered outcomes, access remains limited in many inpatient settings. Oncology hospitalists may be uniquely positioned to deliver elements of primary palliative care during acute hospitalizations. Communication is a core clinical skill in hospital medicine, yet many oncology hospitalists feel underprepared for breaking bad news, discussing prognosis and leading goals-of-care conversations. As providers of primary palliative care, oncology hospitalists help patients and families understand serious illness, explore personal values, and make decisions that align with what matters most to them. However, despite engaging in these conversations routinely, communication training and educational resources specifically tailored to the oncology hospitalist role remain limited.  Methods: Drawing on published literature and established communication frameworks, this narrative review examines the role of oncology hospitalists in delivering primary palliative care communication. Evidence-based frameworks, including SPIKES, NURSE, and Ask–Tell–Ask, are illustrated through representative inpatient oncology case vignettes.  Results: Oncology hospitalists are often the clinicians most consistently present during hospitalization and are therefore well positioned to initiate and revisit goals-of-care discussions, clarify prognosis, and align treatment decisions with patient values. Integrating structured communication approaches into inpatient oncology practice may enhance patient understanding, promote goal-concordant care, and reduce fragmentation. Successful implementation requires formal training, institutional support, and clear role delineation alongside specialty palliative services.  Conclusion: Embedding primary palliative care competencies within the oncology hospitalist model represents a scalable strategy to strengthen inpatient cancer care delivery. As oncology hospitalist programs continue to expand, integrating structured complementary, well-established, frameworks into routine inpatient practice may improve patient-centered care and promote goal-concordant treatment decisions.
SN  - 1073-2748
SN  - 1526-2359
ER  -