Dr. Leslie J. Blackhall, section head for palliative medicine at the UVA School of Medicine, was a pioneer when she started an outpatient palliative care clinic in the UVA Health System Cancer Center in 2001. “My thinking was that we don’t get upstream enough,” she says. Blackhall and her colleagues have demonstrated that outpatient palliative care improves patients’ quality of life: They are much less likely to die in the hospital, to have a hospital admission in the last month of life or to die in an intensive care unit; and they are more likely to be admitted to hospice.