How do you create a palliative care culture at an institution when there isn't one? How do you take the idea of palliative care and turn that into a real program that meets the needs of its patients? For the answers, we turned to Dr. Alexander Gamble, the Medical Director of Supportive Care at Phelps County Regional Medical Center in Rolla, Missouri. In this chat, Dr. Gamble discusses how he is growing a palliative care team from the ground up. Host Dan Altano and Dr. Gamble also chat about building lasting relationships with referring clinicians and the challenges of branching out into the rural setting. .