Treating Patients With Care & Compassion Wellington’s Dr. Katherine Brazzale Is The New Chief Medical Officer At Trustbridge

By Deborah Welky

Dr. Katherine Brazzale, a Wellington resident who was recently promoted to chief medical officer at Trustbridge, grew up in England and was studying to be an architect at University College London when she recognized medicine as her true calling.

Brazzale then fell in love with an American and moved to the United States in 2004. She completed her residency in family medicine at the University of Florida, where she was chief resident at Shands in 2008 before becoming the first-ever physician fellow for hospice and palliative care by Trustbridge that same year.

Trustbridge is the nonprofit umbrella organization for Hospice of Palm Beach County, Hospice of Broward County and Hospice by the Sea. Having long worked with pediatric hospice patients for Trustbridge, Brazzale became chief medical officer for the organization this year.

“I love Trustbridge because it’s nonprofit,” Brazzale said. “Being English, I come from a National Health Service, and I am uncomfortable with the fact that money often delineates what kind of healthcare you get in America. Also, many people are under the impression that ‘hospice’ means that they’re going to take away all your medicines and you’re going to die. Not at Trustbridge. Most of our patients are on Medicare, but Medicare funding is fairly minimal. Here, we can apply to our foundation to get grants for treatments that are not available through regular hospice. For instance, if Medicare doesn’t cover it, but you need a month or two more of dialysis so you can attend your daughter’s wedding, we can go to our foundation for the funding.”

Brazzale said she loves working with her team, a 130-member group comprised of 30 board-certified or board-eligible doctors, as well as nurses, social workers, chaplains and volunteers. She loves their creative process of “finding a way.”

“Whenever a patient needs something, I’m never told no. I’m just asked how I’m going to do it,” Brazzale said. “You have to think outside the box. Some of the situations you walk into, it’s challenging. Most of the patients are very sick, and we get invited into people’s lives — the whole family’s lives. So, I feel it’s a real privilege. They’re in a vulnerable state, and they reveal so much to us. They allow us to get involved.”

What she tells her team, first and foremost, is to listen.

“You have to be so careful when you’re entering someone’s home,” Brazzale said. “You want to create a sense of trust. This person may be in real trouble, and you have to assimilate information very fast. I suggest saying as little as possible. Let them talk. If you look around, are observant, you’ll get clues as to how things are going. You may see a medical drip, an oxygen tank. You may be able to guess what religion they may be or whether they’re alone. In the 15 minutes we are there for a first visit, there are so many pieces of information we gain in homes that can help us, as opposed to in a clinic. I tell my team to remain humble and respectful. Don’t sit down unless invited. Create the relationship from there. Foster a feeling of trust.”

In hospice situations, that can be a challenge.

“Some patients are resentful, filled with hostility. Some view me as the Grim Reaper,” Brazzale said. “Or maybe the daughter thought it was a good idea, but the patient doesn’t want me there. These people typically have a lot of anger. They’re angry that they’re sick, and they’re frightened. The worst thing would be that they don’t let you in or ask you to leave. It can go horribly wrong. You need to tread lightly and listen. You want to meet the needs of the patient, rather than deciding what you think they need. If a patient asks me to leave, I leave. I’ll try to reach out again later, but it depends how much turmoil there is.”

In many situations, the whole family may be under stress. That’s when Brazzale may bring along another team member.

“If a patient is having a hard time with wound care or symptom management, that’s my job,” Brazzale said. “It often helps to have a joint visit that includes a nurse or chaplain. But if a family member or spouse is also having issues, I might bring along a social worker, who can be working with the spouse while I’m working with the patient. That’s the beauty of hospice — you’re working as a team the whole time.”

Trustbridge’s efforts extend beyond the patient in many ways. Among the many bereavement programs offered is Club Seahorse.

“Once a year, children who are bereaved come together in a camp run by Trustbridge volunteers,” she explained. “And we have a bereavement team who reaches out to family members after the patient has passed to let them know that there are bereavement groups out there if they need them.”

Pet therapy and music therapy are also Trustbridge offerings.

“Music therapy is not just entertainment,” Brazzale said. “Particularly in dementia patients, it’s wonderful to see their response to familiar music as the music therapist works with them. That’s what sets Trustbridge apart — inpatient or outpatient, we can supply our patients with these additional things.”

Under Brazzale’s leadership, there will also be increased participation with the Veterans Administration. “We currently partner with them, and we do hold a ceremony for our veterans, but veterans do have specific experiences and specific needs that we need to take into consideration,” she said.

Another push forward is Trustbridge’s partnership with the Joe DiMaggio Children’s Hospital Foundation, which works to provide philanthropic support to ensure the ongoing availability of safe, quality, cost-effective healthcare for children and their families, regardless of ability to pay.

“At Trustbridge, we do applicative care consults in hospitals and hospice for young patients who have six months or more left — as well as palliative care — but our focus is still on getting children home,” Brazzale said. “We always hope that, even with symptoms, people can continue to live their lives.”

As she continues to have a soft spot in her heart for pediatrics, Brazzale hopes her new administrative role doesn’t keep her from one-on-one contact with patients.

“I’ve been with Trustbridge 14 years now,” she said. “I still visit facilities and assisted living centers, and I’m learning a bit more about the administrative work. I’m thrilled to be in this position — a little scared, too. I think healthcare is such a difficult thing, ever-changing. Yet I would rather be in the driving seat, navigating the change, rather than experiencing the change downstream… I hope I never get disconnected from those home visits and become purely administrative and lose sight of that. It’s going to be an adventure.”

To learn more about Trustbridge and its services, call (561) 848-5200 or visit www.trustbridge.com.