James Tulsky, MD, Director Center for Palliative Care , Director Center for Palliative Care

Department:
Medicine

Division:
General Internal Medicine

Physical Address:
Center for Palliative CareHock Plaza, Suite 11052424 Erwin RoadDurham, NC 27705

Appointment Telephone:
(919) 668-7215

Fax Telephone:
(919) 668-1300

Training:
M.D., University of Illinois College of Medicine at Chicago, 1987
Internal Medicine, University of California, San Francisco (UCSF), 1987-1991
Robert Wood Johnson Clinical Scholar, University of California, San Francisco, 1991-1993

Clinical Interests:
Pain and symptom control and improving physician-patient communication,Director of Center for Palliative Care

Publications:
2009 -- Pubmed # 19171703 -- Back AL, Arnold RM, Baile WF, Tulsky JA, Barley GE, Pea RD, Fryer-Edwards KA. Faculty development to change the paradigm of communication skills teaching in oncology. J Clin Oncol. 2009 Mar 1;27(7):1137-41.

2009 -- Pubmed # 19321287 -- Skinner CS, Pollak KI, Farrell D, Olsen MK, Jeffreys AS, Tulsky JA. Use of and reactions to a tailored CD-ROM designed to enhance oncologist-patient communication: The SCOPE trial intervention. Patient Educ Couns. 2009 Mar 23.

2008 -- Pubmed # 18523222 -- Allen LA, Yager JE, Funk MJ, Levy WC, Tulsky JA, Bowers MT, Dodson GC, O'Connor CM, Felker GM. Discordance between patient-predicted and model-predicted life expectancy among ambulatory patients with heart failure. JAMA. 2008 Jun 4;299(21):2533-42.

2008 -- Pubmed # 18227371 -- Johnson KS, Kuchibhatla M, Tanis D, Tulsky JA. Racial differences in hospice revocation to pursue aggressive care. Arch Intern Med. 2008 Jan 28;168(2):218-24.

2008 -- Pubmed # 18771455 -- Johnson KS, Kuchibhatla M, Tulsky JA. What explains racial differences in the use of advance directives and attitudes toward hospice care? J Am Geriatr Soc. 2008 Oct;56(10):1953-8.

2008 -- Pubmed # 19041211 -- Kennifer SL, Alexander SC, Pollak KI, Jeffreys AS, Olsen MK, Rodriguez KL, Arnold RM, Tulsky JA. Negative emotions in cancer care: Do oncologists' responses depend on severity and type of emotion? Patient Educ Couns. 2008 Nov 26.

2008 -- Pubmed # 18196288 -- Robinson TM, Alexander SC, Hays M, Jeffreys AS, Olsen MK, Rodriguez KL, Pollak KI, Abernethy AP, Arnold R, Tulsky JA. Patient-oncologist communication in advanced cancer: predictors of patient perception of prognosis. Support Care Cancer. 2008 Jan 15.

2008 -- Pubmed # 19021487 -- Steinhauser KE, Alexander SC, Byock IR, George LK, Olsen MK, Tulsky JA. Do preparation and life completion discussions improve functioning and quality of life in seriously ill patients? Pilot randomized control trial. J Palliat Med. 2008 Nov;11(9):1234-40.

2008 -- Pubmed # 18198361 -- Taylor DH, Steinhauser K, Tulsky JA, Rattliff J, Van Houtven CH. Characterizing Hospice Discharge Patterns in a Nationally Representative Sample of the Elderly, 1993-2000. Am J Hosp Palliat Care. 2008 Jan 15.

2007 -- Pubmed # 17960430 -- Anderson WG, Alexander SC, Rodriguez KL, Jeffreys AS, Olsen MK, Pollak KI, Tulsky JA, Arnold RM. "What concerns me is..." Expression of emotion by advanced cancer patients during outpatient visits. Support Care Cancer. 2007 Oct 25.

2007 -- Pubmed # 17353492 -- Back AL, Arnold RM, Baile WF, Fryer-Edwards KA, Alexander SC, Barley GE, Gooley TA, Tulsky JA. Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. Arch Intern Med. 2007 Mar 12;167(5):453-60.

2007 -- Pubmed # 17803420 -- Barclay JS, Blackhall LJ, Tulsky JA. Communication strategies and cultural issues in the delivery of bad news. J Palliat Med. 2007 Aug;10(4):958-77.

2007 -- Pubmed # 17555922 -- Johnson KS, Kuchibhatla M, Tanis D, Tulsky JA. Racial differences in the growth of noncancer diagnoses among hospice enrollees. J Pain Symptom Manage. 2007 Sep;34(3):286-93.

2007 -- Pubmed # 17353491 -- Keitz SA, Stechuchak KM, Grambow SC, Koropchak CM, Tulsky JA. Behind closed doors: management of patient expectations in primary care practices. Arch Intern Med. 2007 Mar 12;167(5):445-52.

2007 -- Pubmed # 17915342 -- Munn JC, Zimmerman S, Hanson LC, Williams CS, Sloane PD, Clipp EC, Tulsky JA, Steinhauser KE. Measuring the quality of dying in long-term care. J Am Geriatr Soc. 2007 Sep;55(9):1371-9.

2007 -- Pubmed # 18089870 -- Pollak KI, Arnold RM, Jeffreys AS, Alexander SC, Olsen MK, Abernethy AP, Sugg Skinner C, Rodriguez KL, Tulsky JA. Oncologist communication about emotion during visits with patients with advanced cancer. J Clin Oncol. 2007 Dec 20;25(36):5748-52.

2007 -- Pubmed # 17600605 -- Taylor DH Jr, Ostermann J, Van Houtven CH, Tulsky JA, Steinhauser K. What length of hospice use maximizes reduction in medical expenditures near death in the US Medicare program? Soc Sci Med. 2007 Oct;65(7):1466-78.

2006 -- Pubmed # 17065871 -- Alexander SC, Keitz SA, Sloane R, Tulsky JA. A controlled trial of a short course to improve residents' communication with patients at the end of life. Acad Med. 2006 Nov;81(11):1008-12.

2006 -- Pubmed # 16430350 -- Evans WG, Cutson TM, Steinhauser KE, Tulsky JA. Is There No Place Like Home? Caregivers Recall Reasons for and Experience upon Transfer from Home Hospice to Inpatient Facilities. J Palliat Med. 2006 Feb;9(1):100-10.

2006 -- Pubmed # 17034677 -- Evans WG, Tulsky JA, Back AL, Arnold RM. Communication at times of transitions: how to help patients cope with loss and re-define hope. Cancer J. 2006 Sep-Oct;12(5):417-24.

2006 -- Pubmed # 16799286 -- Fryer-Edwards K, Arnold RM, Baile W, Tulsky JA, Petracca F, Back A. Reflective teaching practices: an approach to teaching communication skills in a small-group setting. Acad Med. 2006 Jul;81(7):638-44.

2006 -- Pubmed # 17040145 -- Johnson KS, Elbert-Avila K, Kuchibhatla M, Tulsky JA. Racial differences in next-of-kin participation in an ongoing survey of satisfaction with end-of-life care: a study of a study. J Palliat Med. 2006 Oct;9(5):1076-85.

2006 -- Pubmed # 17148536 -- Koropchak CM, Pollak KI, Arnold RM, Alexander SC, Skinner CS, Olsen MK, Jeffreys AS, Rodriguez KL, Abernethy AP, Tulsky JA. Studying communication in oncologist-patient encounters: the SCOPE Trial. Palliat Med. 2006 Dec;20(8):813-9.

2006 -- Pubmed # 16908792 -- Smith AK, Ries AP, Zhang B, Tulsky JA, Prigerson HG, Block SD. Resident approaches to advance care planning on the day of hospital admission. Arch Intern Med. 2006 Aug 14-28;166(15):1597-602.

2006 -- Pubmed # 17148529 -- Steinhauser KE, Clipp EC, Hays JC, Olsen M, Arnold R, Christakis NA, Lindquist JH, Tulsky JA. Identifying, recruiting, and retaining seriously-ill patients and their caregivers in longitudinal research. Palliat Med. 2006 Dec;20(8):745-54.

2006 -- Pubmed # 16401817 -- Steinhauser KE, Voils CI, Clipp EC, Bosworth HB, Christakis NA, Tulsky JA. "Are you at peace?": one item to probe spiritual concerns at the end of life. Arch Intern Med. 2006 Jan 9;166(1):101-5.

2005 -- Pubmed # 15890639 -- Back AL, Arnold RM, Baile WF, Tulsky JA, Fryer-Edwards K. Approaching difficult communication tasks in oncology. CA Cancer J Clin. 2005 May-Jun;55(3):164-77.

2005 -- Pubmed # 15838086 -- Back AL, Arnold RM, Tulsky JA, Baile WF, Fryer-Edwards KA. On saying goodbye: acknowledging the end of the patient-physician relationship with patients who are near death. Ann Intern Med. 2005 Apr 19;142(8):682-5.

2005 -- Pubmed # 15817022 -- Johnson KS, Elbert-Avila KI, Tulsky JA. The influence of spiritual beliefs and practices on the treatment preferences of african americans: a review of the literature. J Am Geriatr Soc. 2005 Apr;53(4):711-9.

2005 -- Pubmed # 16398911 -- Johnson KS, Kuchibhatala M, Sloane RJ, Tanis D, Galanos AN, Tulsky JA. Ethnic differences in the place of death of elderly hospice enrollees. J Am Geriatr Soc. 2005 Dec;53(12):2209-15.

2005 -- Pubmed # 16030281 -- Tulsky JA. Beyond advance directives: importance of communication skills at the end of life. JAMA. 2005 Jul 20;294(3):359-65.

2004 -- Pubmed # 15684844 -- Emanuel L, Alexander C, Arnold RM, Bernstein R, Dart R, Dellasantina C, Dykstra L, Tulsky J, . Integrating palliative care into disease management guidelines. J Palliat Med. 2004 Dec;7(6):774-83.

2004 -- Pubmed # 15566436 -- Peck BM, Ubel PA, Roter DL, Goold SD, Asch DA, Mstat AS, Grambow SC, Tulsky JA. Do unmet expectations for specific tests, referrals, and new medications reduce patients' satisfaction? J Gen Intern Med. 2004 Nov;19(11):1080-7.

2004 -- Pubmed # 16594230 -- Steinhauser KE, Clipp EC, Bosworth HB, McNeilly M, Christakis NA, Voils CI, Tulsky JA. Measuring quality of life at the end of life: validation of the QUAL-E. Palliat Support Care. 2004 Mar;2(1):3-14.

2003 -- Pubmed # 12805343 -- Back AL, Arnold RM, Tulsky JA, Baile WF, Fryer-Edwards KA. Teaching communication skills to medical oncology fellows. J Clin Oncol. 2003 Jun 15;21(12):2433-6.

2003 -- Pubmed # 14509486 -- Lo B, Kates LW, Ruston D, Arnold RM, Cohen CB, Puchalski CM, Pantilat SZ, Rabow MW, Schreiber RS, Tulsky JA. Responding to requests regarding prayer and religious ceremonies by patients near the end of life and their families. J Palliat Med. 2003 Jun;6(3):409-15.

2002 -- Pubmed # 12406362 -- Clever SL, Tulsky JA. Dreaded Conversations. J Gen Intern Med. 2002 Nov;17(11):893-894.

2002 -- Pubmed # 12572968 -- Kolarik RC, Arnold RM, Fischer GS, Tulsky JA. Objectives for advance care planning. J Palliat Med. 2002 Oct;5(5):697-704.

2002 -- Pubmed # 11851542 -- Lo B, Ruston D, Kates LW, Arnold RM, Cohen CB, Faber-Langendoen K, Pantilat SZ, Puchalski CM, Quill TR, Rabow MW, Schreiber S, Sulmasy DP, Tulsky JA, . Discussing religious and spiritual issues at the end of life: a practical guide for physicians. JAMA. 2002 Feb 13;287(6):749-54.

2002 -- Pubmed # 12685529 -- Steinhauser KE, Bosworth HB, Clipp EC, McNeilly M, Christakis NA, Parker J, Tulsky JA. Initial assessment of a new instrument to measure quality of life at the end of life. J Palliat Med. 2002 Dec;5(6):829-41.

2002 -- Pubmed # 12133245 -- Steinhauser KE, Clipp EC, Tulsky JA. Evolution in measuring the quality of dying. J Palliat Med. 2002 Jun;5(3):407-14.

2002 -- Tulsky JA, Arnold RM.  Communication at End of Life.  In Berger AM, Portenoy RK, Weissman DE, eds.  

2002 -- Pubmed # 12133239 -- Tulsky JA. Hope and hubris. J Palliat Med. 2002 Jun;5(3):339-41.

2002 -- Pubmed # 12243678 -- Ury WA, Arnold RM, Tulsky JA. Palliative care curriculum development: a model for a content and process-based approach. J Palliat Med. 2002 Aug;5(4):539-48.

2001 -- Pubmed # 11176185 -- Abbott KH, Sago JG, Breen CM, Abernethy AP, Tulsky JA. Families looking back: one year after discussion of withdrawal or withholding of life-sustaining support. Crit Care Med. 2001 Jan;29(1):197-201.

2001 -- Pubmed # 11359545 -- Breen CM, Abernethy AP, Abbott KH, Tulsky JA. Conflict associated with decisions to limit life-sustaining treatment in intensive care units. J Gen Intern Med. 2001 May;16(5):283-9.

2001 -- Pubmed # 11176547 -- Peck BM, Asch DA, Goold SD, Roter DL, Ubel PA, McIntyre LM, Abbott KH, Hoff JA, Koropchak CM, Tulsky JA. Measuring patient expectations: does the instrument affect satisfaction or expectations? Med Care. 2001 Jan;39(1):100-8.

2001 -- Pubmed # 11532586 -- Steinhauser KE, Christakis NA, Clipp EC, McNeilly M, Grambow S, Parker J, Tulsky JA. Preparing for the end of life: preferences of patients, families, physicians, and other care providers. J Pain Symptom Manage. 2001 Sep;22(3):727-37.

2000 -- Pubmed # 10783427 -- Fischer GS, Arnold RM, Tulsky JA. Talking to the older adult about advance directives. Clin Geriatr Med. 2000 May;16(2):239-54.

2000 -- Pubmed # 11112242 -- Roter DL, Larson S, Fischer GS, Arnold RM, Tulsky JA. Experts practice what they preach: A descriptive study of best and normative practices in end-of-life discussions.  Arch Intern Med 2000;160(22):3477-85.

2000 -- Pubmed # 11074777 -- Steinhauser KE, Christakis NA, Clipp EC, McNeilly M, McIntyre L, Tulsky JA. Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA. 2000 Nov 15;284(19):2476-82.

2000 -- Pubmed # 10819707 -- Steinhauser KE, Clipp EC, McNeilly M, Christakis NA, McIntyre LM, Tulsky JA. In search of a good death: observations of patients, families, and providers. Ann Intern Med. 2000 May 16;132(10):825-32.

2000 -- Pubmed # 11033658 -- Steinhauser KE, Maddox GL, Person JL, Tulsky JA. The evolution of volunteerism and professional staff within hospice care in North Carolina. Hosp J. 2000;15(1):35-51.

2000 -- Pubmed # 10733451 -- Tulsky JA, Ciampa R, Rosen EJ. Responding to legal requests for physician-assisted suicide. University of Pennsylvania Center for Bioethics Assisted Suicide Consensus Panel. Ann Intern Med. 2000 Mar 21;132(6):494-9.

2000 -- Tulsky JA.  Book Review: Death Foretold: Prophecy and prognosis in medical care, N Christakis. N Engl J Med; 2000;342(7):522.

2000 -- Pubmed # 10832372 -- Tulsky JA. Ancient wisdom for modern medicine: the tradition of Judaism.  N C Med J.2000;61(3):141-4.

1999 -- Pubmed # 10507632 -- Danis M, Federman D, Fins JJ, Fox E, Kastenbaum B, Lanken PN, Long K, Lowenstein E, Lynn J, Rouse F, Tulsky J. Incorporating palliative care into critical care education: principles, challenges, and opportunities. Crit Care Med. 1999 Sep;27(9):2005-13.

1999 -- Pubmed # 10357694 -- Lo B, Quill T, Tulsky J. Discussing palliative care with patients. ACP-ASIM End-of-Life Care Consensus Panel. American College of Physicians-American Society of Internal Medicine. Ann Intern Med. 1999 May 4;130(9):744-9.

1998 -- Pubmed # 9686710 -- Fischer GS, Tulsky JA, Rose MR, Siminoff LA, Arnold RM. Patient knowledge and physician predictions of treatment preferences after discussion of advance directives. J Gen Intern Med. 1998 Jul;13(7):447-54.

1998 -- Pubmed # 9735081 -- Tulsky JA, Fischer GS, Rose MR, Arnold RM. Opening the black box: how do physicians communicate about advance directives? Ann Intern Med. 1998 Sep 15;129(6):441-9.

1997 -- Pubmed # 9054283 -- Hanson LC, Tulsky JA, Danis M. Can clinical interventions change care at the end of life? Ann Intern Med. 1997 Mar 1;126(5):381-8.

1997 -- Pubmed # 9302632 -- Tulsky JA, Cassileth BR, Bennett CL. The effect of ethnicity on ICU use and DNR orders in hospitalized AIDS patients.  J Clin Ethics 1997;8(2):150-7.

1996 -- Pubmed # 8628340 -- Diem SJ, Lantos JD, Tulsky JA. Cardiopulmonary resuscitation on television. Miracles and misinformation. N Engl J Med. 1996 Jun 13;334(24):1578-82.

1996 -- Pubmed # 8835470 -- Tulsky JA, Alpers A, Lo B. A middle ground on physician-assisted suicide.  Camb Q Healthc Ethics 1996;5(1):33-43.

1996 -- Pubmed # 8651836 -- Tulsky JA, Chesney MA, Lo B. See one, do one, teach one? House staff experience discussing do-not-resuscitate orders. Arch Intern Med. 1996 Jun 24;156(12):1285-9.

1996 -- Pubmed # 8889889 -- Tulsky JA, Stocking CB. Obstacles and opportunities in the design of ethics consultation evaluation.  J Clin Ethics 1996;7(2):139-45.

1995 -- Pubmed # 7472700 -- Tulsky JA, Chesney MA, Lo B. How do medical residents discuss resuscitation with patients? J Gen Intern Med. 1995 Aug;10(8):436-42.

1992 -- Pubmed # 1558079 -- Tulsky JA, Lo B. Ethics consultation: time to focus on patients. Am J Med. 1992 Apr;92(4):343-5.