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Robert M. Arnold, MD

Leo H. Creip Chair of Patient Care, Department of Medicine

Director, Palliative Care Service

Director of the Institute for Doctor-Patient Communication

University of Pittsburgh

Medical Director Palliative and Supportive Care Institute of UPMC

Contact:

rabob@pitt.edu

412-692-4834

 

Address:

UPMC Montefiore

Suite 932W

200 Lothrop Street

Pittsburgh, PA 15213

 

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Related Sites:

Oncotalk

 

Dr. Arnolds General Internal Medicine Faculty Page

Robert M. Arnold is the Center’s Director of Clinical Training. He is a Professor in the Division of General Internal Medicine, Department of Medicine. In 1997, he formed the Section of Palliative Care and Medical Ethics, where he is now Chief. In 2000, Dr. Arnold was named the first Leo H. Creip Chair of Patient Care. The chair emphasizes the importance of the doctor-patient relationship, particularly at the end of life. Dr. Arnold is the Director of the Institute for Doctor-Patient Communication and a Co-Director of the Institute to Enhance Palliative Care. A board-certified internist, he is clinically active in both HIV and palliative care.

 

Dr. Arnold has published extensively on ethical issues in end-of-life care, hospice and palliative care, doctor-patient communication, and on ethics education. His current research interests are focused on educational interventions to improve communication in life-limiting illnesses and to understand how ethical precepts are implemented in clinical practice. He has been heavily involved in Oncotalk and Oncotalk-Teach, an evidence-based method to teach oncology fellows communication skills. He recently received funding from the National Palliative Care Research Center, the Arthur Vining Davis Foundation and the Jewish Health Care Foundation to develop a similar program for intensivists regarding critical care communications. Previously Secretary/Treasurer and National Meeting Chair of the American Society for Bioethics and Humanities, he currently serves on the Board of Directors of the American Board of Hospice Medicine. He is also a Past President of the American Academy of Hospice and Palliative Medicine and of the Society for Health and Human Values (in 1996-1997).

Education

Medical Ethics Practicum Certificate – University of Tennessee, Memphis (1982)
Graduate level philosophy with emphasis on medical ethics – University of Tennessee, Knoxville (1982)
BA – Biology and Philosophy, University of Missouri (1983)                                             
MD – University of Missouri, Kansas City School of Medicine (1986)                                           
Residency – General Internal Medicine, Rhode Island Hospital (1986-1988)

Awards, Honors, and Fellowships

University of Missouri-Kansas City Alumnus of the Year Award (2008)
American Academy of Hospice and Palliative Medicine/Hospice
and Palliative Nurses Association Pioneer in Palliative Care Award (2008)
Who’s Who in Medical Sciences Education (2005)
Guide to America’s Top Physicians (2003)
American Society of Bioethics and Humanities Distinguished Service Award (2000)

Research and Professional Interests

Undergraduate and graduate medical education for end-of-life care
Doctor-patient Communication
Palliative medicine

Symptom burden in chronic dialysis patients

Research Support: Ongoing

Geriatric Education Centers of Pennsylvania 

Robert Arnold, MD, (Co-Investigator) 

Funding Agency: HRSA 

Five year grant to educate home clinicians about evidence based palliative care interventions in an effort to improve the quality of life of nursing home residents.

 

End of Life in Very Old Age

Robert Arnold, MD (Co-Investigator)

Funding Agency: NIH

In follow-up of participants in the Health, Aging and Body Composition cohort (Health-ABC), this prospective study will follow the clinical course of these participants, now age 85+, to (i) characterize clinical trajectories and risk of death in very old age, (ii) assess participant and proxy decisoin-making, and (iii) examine predictors of hospitalization and emergency department care.

 

Communication on Illicit Drug and/or Alcohol in Obstetrics

Robert Arnold, MD (Co-Investigator)

Funding Agency: NIH

The overall goal of this research is to identify communication styles and processes that are most successful in engaging pregnant women who use alcohol and/or durgs in behavior change for the benefit of their baby's health.

 

A Trial to Improve Surrogate Decision-Making for Critically Ill Older Adults

Robert Arnold, MD (Co-Investigator)

Funding Agency: NIA

This project will conduct a multi-center efficacy of the Four Supports Intervention among 400 critically ill older adults. The central hypothesis is that by intensively supporting surrogates in this highly stressful circumstance, the Four Supports Intervention will improve key elements of decision making, decrease long-term psychological distress among surrogates, and achieve more patient-centered care near the end of life.

 

K12 HS 022989-01 (Kapoor)

Robert Arnold, MD (Co-Investigator)

Funding Agency: AHRQ

Three related initiatives of this project include (1) training clinicians providing palliative care consults at six community or rural hospitals; (2) training hospitalists to provide primary palliative care at our six largest hospitals; and (3) evaluating these models of palliative care.

 

Improving Seriously Ill Patients End-of-Life Care by Changing the Default Option in Advance Directives

Robert Arnold, MD (Co-Investigator)

Funding Agency: Gordon and Betty Moore Foundation/University of Pennsylvania

This project will test the premise that Advance Directives can better align the end-of-life care patients receive with the care they want if the directives are restructured such that comfort-oriented care is provided as the default, rather than forcing patients to make emotionally and existentually challenging choices to review it.

Selected Publications

Chang J, Day N, Kraemer K, Rubio D, Arnold RM. "Perinatal Marijuana Use: An Observational Study Examining Prevalence, Screening, and Disclosure. American Journal of Health Promotion (in press).

 

Jordan A, Maree R, Korzon D, Arnold RM, Schenker Y, Reynolds C. "Depression in Older Adults: A Palliative Medicine Perspective." Harvard Review of Psychiatry (in press).

 

Hall DE, Hanusa BH, Stone RA, Ling BS, Arnold RM. "Time Required for Institutional Review Board Review at one Veterans Affairs Medical Center." JAMA, 2015; PMID: 25701437

 

Porter LS, Pollak KI, Farrell D, Cooper M, Arnold RM, et al. "Development and Implementation of an Online Program to Improve How Patients Communicate Emotional Concerns to their Oncology Providers." Supportive Care in Cancer, 2015; PMID: 25701437

 

Chiarchiaro J, Buddadhumaruk P, Arnold RM, White DB. "Quality of Communication in the ICU and Surrogate's Understanding of Prognosis." Critical Care Medicine, 2015; 43(3):542-8. NIHMSID: NIHMS628666, PMID: 25687030, PMCID: PMC4336600

 

Klein-Fedyshin M, Ketchum AM, Arnold RM, Fedyshin PJ. "Evaluating the MEDLINE Core Clinical Journals Filter: Data-driven Evidence Assessing Clinical Utility." Journal of Evaluation in Clinical Practice, 2014; 20(6):837-43. PMID: 24904948

 

Lupu DE, Ivanko B, Insana F, White PH, Arnold RM. "Hospice Innovation Impediments: Can Halfway Efforts Tame the Terrible Choice? Journal of Palliative Medicine, 2014; 17(10): 1088-90. PMID: 25225847

 

Weisbord SD, Mor MK, Sevick, MA, Shields AM, Rollman BL, Arnold RM et al. "Associations of Depressive Symptoms and Pain with Dialysis Adherence, Health Resource Utilization, and mortailty in Patients Receiving chronic demodialysis." Clinical Journal of the American Society of Nephrology: CJASN. 2014; 9(9):1594-602. PMID: 25081360, PMCID: PMC4152801