This podcast features a conversation with Gregg VandeKieft, MD, MA, Medical Director for Palliative Care at Providence St. Peter Hospital, a Magnet Hospital in Washington. Palliative Care at Providence St. Peter Hospital is doing well. The program has done a great job engaging primary care clinicians to increase referrals, their institution has bought into their model, and they are staffed with a full time group committed to the cause. But with success comes growing pains and new obstacles. A recent study showed that the majority of hospitals offering palliative care services fail to meet national staffing guidelines. The study looked at over 400 palliative care programs and found that only 25 percent have all recommended staff positions filled full-time. In this conversation with Doctor VandeKieft—whose team does meet the national standard—we discuss his philosophy on training and retaining a robust team of fill time staff to meet their growing need. We also discuss the evolution of palliative care in the last fifteen years and a host of other topics.