University of Washington assistant professor and Kirkland resident Dr. Rashmi Sharma received the 2016 Hastings Center Cunniff-Dixon Early Career Physician Award for improving end-of-life care.

Only one of three doctors to receive the award nationally, the 38-year-old said her work has focused on decreasing inequality in palliative care, specifically focusing on racial, ethnic, socioeconomic and gender differences.

“I think talking about something like end-of-life care can seem really scary to people,” she said. “It’s kind of the wanting to encourage what is the difficult but really important conversations that should be happening with their physicians and family members.”

For her research, Sharma is analyzing conversations between doctors, patients and their families in advanced cancer cases as they try to figure out how to improve communication, an issue which she has been thinking about since her fellowship started in 2007.

Many factors play into a disparity in palliative care, Sharma said.

Among these are religious obligations, distrust of the doctor, racism and discrimination between all parties. Sharma said they are looking at all these factors and more to create a more holistic palliative care model.

“I think the idea with palliative care is very much to look at the whole patient and the family,” she said. “We have to be able to think about about both the patient and the family within the health care setting.”

Sharma said she has seen the effects of both poor and good communication in outcomes for patients and their families. When the doctors knew how to effectively communicate with sensitivity to the families and explain their options for treatment the families were better able to make difficult decisions.

But when communication was poor and something went wrong, the effects on families could be devastating.

“When things went wrong, it had lasting effects on the families, like families would remember when loved ones died,” she said.

Honesty about hard topics like prognosis and life expectancy should be brought up at the right time, Sharma said. Sometimes it was better to wait and tell the patients these things, and other times doctors should tell patients and their families immediately.

The next step in her research is compiling and analyzing doctor’s conversations to come up with recommendations on how palliative physicians can improve their communications.

“A key art of communication is figuring out where the other person is at and meeting them at that place,” Sharma said.

The Cunniff-Dixon Foundation was created in 2005 in honor of Carley Cunniff and in recognition of Dr. Peter S. Dixon. Cunniff died after a three-year battle with breast cancer, and Dixon was her attending physician who aided her greatly.

The award was presented on June 15.