Who Should Deliver Palliative Care in Liver Disease? Chris Woodrell, Manisha Verma, Marie Bakitas

Who's better at delivering palliative care to patients with liver disease: palliative care specialists, or hepatologists who have received liver disease-specific palliative care training?

That's the question we take a deep dive into on this week's podcast by breaking down the PAL-LIVER trial, published this year in JAMA Internal Medicine. We've invited three of the trial's authors, Manisha Verma, Chris Woodrell, and Marie Bakitas, to discuss this cluster-randomized clinical trial spanning 19 U.S. medical centers.

We'll discuss:

Why was this trial done?

Do we really need to run a separate palliative care trial for every single organ disease?

What kind of specialized palliative care training did the hepatologists receive?

What exactly is meant by the finding that hepatologists were not statistically superior, but were shown to be statistically non-inferior?

Lastly, we discuss whether these results change anyone's practice, and whether healthcare systems should decide which type of palliative care model to fund (primary vs. specialty.)

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References we discussed

Developing palliative care interventions in liver disease using formative and summative qualitative evaluation. Hepatology 2026

Palliative Care for Advanced Liver Disease: Hepatology and Palliative Care Specialists Experiences. J Pain Symptom Manage 2026