2014 Health Care Heroes: Susan Hickman, Ph.D. and Gerald Walthall, M.D., FACS

Tom Harton
March 6, 2014
Back to TopCommentsE-mailPrintBookmark and Share

Health Care HeroesAdvancements in Health Care

Susan Hickman, Ph.D., Associate Professor of Nursing, Indiana University School of Nursing, and Gerald Walthall, M.D., FACS, Medical Director of Palliative Medicine, Franciscan St. Francis Health

 Dr. Gerald Walthall and Susan Hickman are from different generations, come from very different backgrounds and even have some political differences, but they joined forces four years ago in a quest to help the sickest Hoosiers die with dignity.

Walthall, 71, is medical director of palliative medicine at Franciscan St. Francis Health. Hickman, 43, is a geriatric psychologist and an associate professor of nursing at the Indiana University School of Nursing. Not long after she arrived here from Oregon in 2009, Walthall heard her give a talk about a model that had been employed in other states to help the very ill avoid going through costly and futile medical procedures at the end of life.

hch_walthall_paybe.jpg Susan Hickman, Ph.D. and Gerald Walthall, M.D., FACS (IBJ Photo/Eric Learned)

Walthall was intrigued and arranged a breakfast with Hickman and others who were interested in bringing the model to Indiana.

The result is the Physician Order for Scope of Treatment form, known as POST, which was approved by the Indiana General Assembly last year. The form, available to people who have a condition that is expected to end their life within a year, is a physician order that limits the lengths health care providers can take to save the patient’s life. POST differs from an advanced directive or living will because it is a valid doctor’s order that can be put into effect immediately.

The form is acted upon only if signed by a doctor, and it’s signed by a doctor only after extensive discussion with the patient about the ramifications.

“It’s not about what the kids want or what Mom wants; it’s about what the person lying in the bed wants,” Walthall said. But POST also benefits the family, Hickman said, by eliminating the stress of having to make difficult decisions at a time when emotions run high.

Before she came to Indiana, Hickman did research funded by the National Institutes of Health to study how similar forms have worked in Oregon, West Virginia and Wisconsin, and to identify states that lacked a way for the seriously ill to avoid unnecessary treatment.

Indiana was one of those states, and although Hickman didn’t move here for that reason, her arrival certainly hastened the creation of the POST form in Indiana.

She and Walthall formed the Indiana Patient Preference Coalition to press the case with the Legislature. They were joined in the coalition by the Indiana State Medical Association, the Indiana Academy of Family Physicians, the Indiana Hospital Association, Indiana AARP and many other senior advocacy groups.

Now that the form is authorized and in use, the coalition has shifted its focus to implementation and education and is looking for an organization to take ownership and become the go-to source for information about POST.

In the meantime, doctors are being educated about making the form available to patients, and paramedics and others are being trained to look for the bright pink form when they come into contact with patients.

It might be three to five years before POST is fully implemented, Hickman said. She expects it to take that long to spread the word about the form, which is a version of what’s now being used in about 16 states.•



Post a comment to this story

We reserve the right to remove any post that we feel is obscene, profane, vulgar, racist, sexually explicit, abusive, or hateful.
You are legally responsible for what you post and your anonymity is not guaranteed.
Posts that insult, defame, threaten, harass or abuse other readers or people mentioned in IBJ editorial content are also subject to removal. Please respect the privacy of individuals and refrain from posting personal information.
No solicitations, spamming or advertisements are allowed. Readers may post links to other informational websites that are relevant to the topic at hand, but please do not link to objectionable material.
We may remove messages that are unrelated to the topic, encourage illegal activity, use all capital letters or are unreadable.

Messages that are flagged by readers as objectionable will be reviewed and may or may not be removed. Please do not flag a post simply because you disagree with it.

Sponsored by

facebook - twitter on Facebook & Twitter

Follow on TwitterFollow IBJ on Facebook:
Follow on TwitterFollow IBJ's Tweets on these topics:
Subscribe to IBJ
  1. So as I read this the one question that continues to come to me to ask is. Didn't Indiana only have a couple of exchanges for people to opt into which were very high because we really didn't want to expect the plan. So was this study done during that time and if so then I can understand these numbers. I also understand that we have now opened up for more options for hoosiers to choose from. Please correct if I'm wrong and if I'm not why was this not part of the story so that true overview could be taken away and not just parts of it to continue this negative tone against the ACA. I look forward to the clarity.

  2. It's really very simple. All forms of transportation are subsidized. All of them. Your tax money already goes toward every single form of transportation in the state. It is not a bad thing to put tax money toward mass transit. The state spends over 1,000,000,000 (yes billion) on roadway expansions and maintenance every single year. If you want to cry foul over anything cry foul over the overbuilding of highways which only serve people who can afford their own automobile.

  3. So instead of subsidizing a project with a market-driven scope, you suggest we subsidize a project that is way out of line with anything that can be economically sustainable just so we can have a better-looking skyline?

  4. Downtowner, if Cummins isn't getting expedited permitting and tax breaks to "do what they do", then I'd be happy with letting the market decide. But that isn't the case, is it?

  5. Patty, this commuter line provides a way for workers (willing to work lower wages) to get from Marion county to Hamilton county. These people are running your restaurants, hotels, hospitals, and retail stores. I don't see a lot of residents of Carmel working these jobs.