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Palliative medicine is the medical subspecialty dedicated to improving quality of life for patients with serious, complex, or life-limiting illness — and for their families. It is a distinct discipline from hospice care, though palliative care physicians frequently oversee or coordinate hospice services as part of their practice. Under the Medicare Hospice Benefit, patients generally qualify when physicians certify a prognosis of six months or less if the terminal illness runs its normal course. Eligible patients may remain enrolled beyond six months if they continue to meet recertification requirements.

Palliative care physicians and palliative care providers work across a wide range of serious conditions, including:

• Advanced cancer and oncology-related symptoms
• Heart failure and advanced cardiovascular disease
• Chronic obstructive pulmonary disease and advanced lung disease
• Kidney failure, advanced chronic kidney disease, and dialysis-related symptom burden
• Dementia and neurodegenerative diseases including ALS and Parkinson's disease
• Serious neurological conditions including stroke and traumatic brain injury
• Liver disease and end-stage hepatic failure
• HIV and other serious or advanced infectious diseases
• Pediatric serious illness and life-limiting conditions in children
• Post-ICU syndrome and complex post-acute care needs

Palliative care physicians are expert practitioners of pain and symptom management, advance care planning, goals-of-care conversations, and multidisciplinary team leadership. They work closely with oncologists, hospitalists, intensivists, primary care physicians, social workers, chaplains, and nursing staff — as well as advanced practice providers including nurse practitioners and physician assistants — to deliver coordinated, compassionate care aligned with each patient's values and wishes.

Physicians and advanced practice providers pursuing palliative medicine jobs have access to a wide range of career pathways, including:

• Hospital-Based Palliative Care Physician: Providing inpatient palliative care consultations for patients with serious disease, managing complex symptoms, and facilitating goals-of-care conversations across a health system's multidisciplinary team
• Hospice Physician or Medical Director: Providing medical oversight of hospice care and completing or contributing to required eligibility certifications and recertifications in accordance with applicable Medicare and organizational requirements
• Outpatient Palliative Care Physician: Delivering longitudinal palliative care in clinic-based settings, often alongside oncology or other subspecialty practices, to patients managing chronic or progressive serious disease
• Academic Palliative Medicine Physician: Teaching fellows and trainees, conducting research in symptom management, communication science, or health policy, and advancing the evidence base for palliative care in university or medical school settings
• Pediatric Palliative Care Physician: Providing palliative care to children and their families across pediatric oncology, neonatal, and complex care settings
• Palliative Care Program Director or Medical Director: Leading health system palliative care programs, developing quality metrics, and expanding access to palliative services across inpatient and outpatient settings
• Community or Home-Based Palliative Care Provider: Delivering palliative care in community and home settings, extending access to patients with serious disease who cannot easily travel to hospital-based programs

Palliative medicine jobs are available across academic medical centers, community hospitals, hospice organizations, integrated health systems, Veterans Affairs medical centers, cancer centers, long-term care facilities, and home-based palliative care programs.

The demand for palliative care physicians and palliative care providers is substantial and growing. A 2025 Palliative Medicine Reports white paper estimated approximately 7,000 hospice and palliative medicine physicians in practice and cited a need for substantially more specialist capacity over the coming decade. Workforce estimates vary by staffing assumptions, but current literature consistently identifies an insufficient specialty physician pipeline relative to projected serious illness needs. Current HPM training capacity includes roughly 450 one-year fellowship positions, with approximately 350–400 physicians completing fellowship each year — a pipeline that falls significantly short of what is needed as the population ages and the prevalence of serious disease increases.

A 2019 Health Affairs workforce model, based on 2018 clinician data, projected a potential ‘workforce valley’ driven by retirements, burnout, and insufficient training capacity.

Compensation for palliative care physicians varies based on practice setting, geographic market, experience level, and whether the role is primarily inpatient, hospice-based, or outpatient. Palliative care providers in health system leadership, medical director, or academic roles may receive supplemental compensation tied to administrative responsibilities or research productivity. Many employers are enhancing compensation packages with sign-on bonuses, loan repayment incentives, and flexible scheduling to attract palliative care physicians to high-need markets. For current compensation benchmarks by specialty, download our Annual Physician Compensation and Placement Summary.

Tangible Benefits:

• Competitive compensation with growing incentive structures in high-need markets
• Comprehensive health, dental, and retirement benefits
• CME allowances and professional development support
• Flexible scheduling models common in many palliative medicine roles, including home-based and outpatient positions
• Loan repayment opportunities through institutional and federal programs
• Relocation assistance and sign-on incentives in select markets

Intangible Benefits:

• Profound sense of purpose and meaning derived from caring for patients and families facing serious disease at the most important moments of life
• Deep, longitudinal patient relationships across serious illness trajectories
• Opportunity to lead multidisciplinary teams and shape the culture of compassionate care within a health system
• Growing national and institutional recognition of palliative care physicians and palliative care providers as essential to high-quality, high-value healthcare
• Intellectual engagement across symptom management, communication science, ethics, and systems-level care improvement

Hard Skills:

• Expertise in multimodal pain management, including opioid and non-opioid pharmacology and appropriate referral for interventional pain procedures when indicated
• Proficiency in managing complex symptoms of serious disease including dyspnea, nausea, delirium, anxiety, and existential distress
• Ability to assess prognosis and communicate findings clearly and compassionately to patients and families
• Knowledge of hospice eligibility, the Medicare Hospice Benefit, and the regulatory landscape governing end-of-life care
• Familiarity with advance care planning documentation, including advance directives, code-status orders, and state-specific portable medical orders such as POLST/MOLST where applicable
• Understanding of ethics consultation, medical decision-making capacity, and surrogate decision-making frameworks
• Ability to supervise and collaborate effectively with advanced practice providers within a multidisciplinary team

Soft Skills:

• Exceptional communication skills — particularly in delivering serious news and facilitating goals-of-care conversations with patients facing serious disease
• Deep empathy and emotional resilience in the face of patient suffering and loss
• Collaborative leadership of multidisciplinary palliative care and hospice teams including advanced practice providers, social workers, and chaplains
• Cultural humility and sensitivity to diverse patient and family values, beliefs, and traditions around serious illness and death
• Ability to navigate complex family dynamics and institutional systems simultaneously

Palliative care physicians and palliative care providers working across practice settings commonly:

• Conduct comprehensive palliative care consultations for patients with serious disease, complex illness, or life-limiting conditions
• Assess and manage pain, dyspnea, nausea, delirium, and other distressing symptoms
• Facilitate goals-of-care conversations with patients, families, and multidisciplinary clinical teams
• Assess prognosis and, when practicing in a hospice role, complete applicable hospice eligibility certifications or recertifications
• Develop and document individualized advance care plans aligned with patient values and goals
• Coordinate transitions of care including hospital-to-hospice, hospital-to-home, and inpatient-to-outpatient palliative care
• Lead or participate in multidisciplinary team meetings focused on patients with serious disease
• Supervise and collaborate with advanced practice providers including nurse practitioners and physician assistants
• Consult on complex ethical questions including medical decision-making capacity and surrogate decision-making
• Educate medical students, residents, and clinical staff on palliative medicine principles and communication skills
• Contribute to program development, quality improvement, and research in palliative care

The typical pathway to palliative medicine jobs for palliative care physicians includes:

• Undergraduate degree with premedical coursework
• Medical school (MD or DO)
• Residency training in a primary specialty — most commonly internal medicine, family medicine, emergency medicine, anesthesiology, psychiatry, neurology, or surgery
• Fellowship in hospice and palliative medicine (typically one year), accredited by the ACGME
• Board certification in hospice and palliative medicine is available to eligible physicians from a broad range of primary specialties through a multi-board ABMS pathway. ABIM administers the common HPM certification examination for its diplomates and eligible physicians from participating boards

Advanced practice providers pursuing careers in palliative care — including nurse practitioners and physician assistants — typically complete graduate-level training in their respective disciplines along with specialized palliative care education, and increasingly play a central role in extending the reach of multidisciplinary palliative care teams to patients with serious disease across all settings.

Notably, palliative medicine is one of the few medical subspecialties open to physicians from a broad range of primary specialty backgrounds. The hospice and palliative medicine certification examination is co-sponsored by ten American boards — including ABIM, the American Board of Family Medicine, the American Board of Anesthesiology, the American Board of Emergency Medicine, the American Board of Pediatrics, and others — reflecting the specialty's truly interdisciplinary nature. Beginning in 2024, ABIM moved to offering the hospice and palliative medicine certification examination annually, reflecting the growing size and importance of the field.

Advancing in palliative medicine requires ongoing engagement with a rapidly growing evidence base, evolving policy landscape, and deepening clinical expertise in symptom management and serious illness communication. Palliative care physicians can pursue additional expertise in areas such as pediatric palliative care, oncologic palliative medicine, neuro-palliative care, or palliative care research to develop subspecialty depth within an already focused field.

Board certification or board eligibility in Hospice and Palliative Medicine is commonly required or preferred for specialist physician positions, depending on the employer and role. Active participation in professional organizations such as the American Academy of Hospice and Palliative Medicine (AAHPM), the Center to Advance Palliative Care (CAPC), and the Hospice and Palliative Nurses Association (HPNA) provides access to clinical education, advocacy resources, workforce data, and national peer networks for both physicians and advanced practice providers.

Physicians interested in academic medicine can pursue research in pain and symptom management, serious illness communication, advance care planning policy, or health equity in palliative care access. Those in clinical practice can seek roles as palliative care program directors, hospice medical directors, or health system leaders overseeing the integration of palliative medicine across inpatient and outpatient settings. Given the specialty's emphasis on multidisciplinary team leadership, palliative care physicians are exceptionally well positioned for broader health system leadership roles.

Palliative medicine presents both significant challenges and compelling opportunities for palliative care physicians, palliative care providers, and advanced practice providers drawn to this work. Burnout is a recognized concern in the specialty, rooted in the emotional demands of caring for patients with serious disease and their families, navigating complex systems, and managing high caseloads with insufficient workforce depth. Addressing burnout through institutional support, sustainable scheduling, and investment in multidisciplinary team models is an active priority for health systems and professional organizations alike.

Compensation in palliative medicine has historically lagged behind other internal medicine subspecialties, in part because palliative care services have been undervalued within fee-for-service payment models that reward procedural volume over care coordination and communication. Federal proposals such as the Palliative Care and Hospice Education and Training Act (PCHETA), reintroduced in Congress in 2025, seek to expand palliative-care education, training, faculty development, and workforce capacity; as of 2026, the legislation has not been enacted.

At the same time, the opportunity in palliative medicine has never been greater. Evidence supports early integration of palliative care for appropriate patients, including improvements in symptom management, quality of life, communication, and care alignment; effects on healthcare utilization and cost vary by population and care model. Health systems, payers, and policymakers are increasingly recognizing palliative care physicians and palliative care providers as essential infrastructure for high-quality, value-based care. Telepalliative care is extending the reach of multidisciplinary palliative care teams into rural and underserved communities that have historically lacked access to specialty palliative care. And growing public awareness of the benefits of early palliative care is steadily reducing the stigma that once limited timely referrals.

For physicians and advanced practice providers motivated by purpose, relationship, and the opportunity to change what it means for a patient to live well with serious disease, palliative medicine offers one of the most meaningful career paths in medicine.

1. American Academy of Hospice and Palliative Medicine (AAHPM). Certification Resources. https://aahpm.org/career-resources/certification/
2. American Board of Internal Medicine (ABIM). Hospice and Palliative Medicine Certification Policies. November 2024. https://www.abim.org/certification/policies/internal-medicine-subspecialty-policies/hospice-palliative-medicine
3. American Board of Internal Medicine (ABIM). ABIM to Offer Hospice and Palliative Medicine Certification Exam Annually Beginning in 2024. https://www.abpmr.org/NewsCenter/Detail/hpm-subspecialty
4. Palliative Medicine Reports. A Strategic Path Forward for Hospice and Palliative Care. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12410326/
5. Health Affairs. Policy Changes Key to Promoting Sustainability and Growth of the Specialty Palliative Care Workforce. https://www.healthaffairs.org/doi/10.1377/hlthaff.2019.00018
6. California Health Care Foundation. Workforce Capacity in Palliative Care. https://www.chcf.org/resource/californias-palliative-care-evolution/opportunities/4-workforce-capacity/
7. The Medicus Firm. Annual Physician Compensation and Placement Summary. https://www.themedicusfirm.com/resources/publications/compensation-and-placement-survey/
8. National Coalition for Hospice and Palliative Care. Clinical Practice Guidelines for Quality Palliative Care, 4th Edition. https://www.nationalcoalitionhpc.org/clinical-practice-guidelines/
9. Association of American Medical Colleges (AAMC). Addressing the Physician Workforce Shortage. March 2024. https://www.aamc.org/advocacy-policy/addressing-physician-workforce-shortage