How Does a Palliative Care Clinician Keep Up With the Evidence?

Palliative care asks us to hold uncertainty with patients every day. What I did not expect was how much of my own professional uncertainty would come from a quieter source: the steady, unrelenting growth of the literature I was supposed to have read but hadn't.

This is a piece about that problem, and about the small, unglamorous habit I built to deal with it. I offer it in case it is useful to a colleague somewhere — particularly someone early in their palliative care career, juggling a busy caseload and wondering how anyone keeps up.

The problem I kept running into

The honest version is this: I was not reading enough. Not through lack of care, but through lack of time and too many competing demands.

The volume of new evidence exceeded what I could realistically read. The gap between what was published and what I had actually read kept widening. And each week I had to decide, from scratch, what was worth reading — and often didn't decide at all.

The result is familiar to most of us. We mean to catch up "at the weekend," and the weekend rarely delivers.

Why "just look it up" is not enough

The obvious answer is that we no longer need to keep up, because we can search the moment a question arises. Modern search engines and question-answering AI are genuinely good at this. I use them.

But there is a catch that took me too long to see. These tools answer the questions you bring to them. They do not tell you what you should have brought.

A clinician who has read nothing new this month does not know what they are missing, so they do not know what to ask. Search is brilliant for the known unknown. It does nothing for the unknown unknown — the new trial, the changed guidance, the reframed debate you would only meet by reading broadly, before you had a specific question.

Keeping up and looking up are two different jobs. We have quietly let the first collapse into the second.

What actually worked: a small reading rule

A few years ago I read Atomic Habits by James Clear — a book that genuinely changed how I think about behaviour change. Its central idea is deceptively simple: the goal is not intensity but consistency, not motivation but systems.

I tried to apply that to my problem with the literature. What emerged was not a grand plan but a small, durable habit. Not the heroic two-hour session I kept promising myself, but a fixed, deliberate, almost boring system:

• A set time each week. Same slot, protected, short. Mine is Monday morning, 08:30, with a coffee before handover.
• A fixed source, chosen in advance. A pre-chosen weekly digest — for me, The Monday Clinical Brief — so the draining "what should I read?" decision is already made before I sit down.
• Permission to read the summary and stop. Not every paper needs the full text. Most weeks I identify the two or three papers that will actually change my practice, and focus there.

The point is not the half hour. The point is removing the weekly decision. A habit you do not have to re-justify every Monday is a habit that survives a busy clinical week.

The mistakes I made — so you don't have to

Looking back, most of my early attempts failed for predictable reasons.

I aimed too high. My first plan was two hours a week; it collapsed within a month. Small and sustainable beats ambitious and abandoned.

I treated reading as something to do after the clinical work. Anything that happens "after the clinical work" never happens. It has to sit inside the week, not be appended to it.

I chased breadth before relevance. I tried to follow everything. Narrowing to what genuinely changes palliative practice made the habit lighter and more useful.

And I confused saving articles with reading them. A folder of unread papers is not knowledge. It is guilt with a filename.

If you are starting from scratch

The principles from Atomic Habits translate surprisingly well:

• Start absurdly small. Fifteen minutes you keep beats sixty you abandon.
• Pick the slot, not just the intention. "Monday morning, first coffee" survives; "more often" does not.
• Let the summary be enough. Depth on demand; breadth on schedule.
• Make it social. A two-line message to a colleague about one paper does more for retention than any private filing system.
• Forgive the missed weeks. A habit is defined by its return after a gap, not by an unbroken streak.

Why this matters in our specialty

Palliative medicine is not a field where the evidence sits still. Symptom control, opioid and anticipatory prescribing, advance care planning, the case for early specialist referral — all have shifted materially in recent years. And the relevant papers are scattered: some in the dedicated palliative journals, some in the general medical press with no "palliative" label attached.

What we read shapes what we offer at the bedside — how we manage a symptom, frame a conversation, support a family through uncertainty. I used to think keeping up required large amounts of time I did not have. In practice it turned out to require something smaller and more repeatable: a system that makes sure new evidence crosses my path each week, whether I feel motivated or not.

The difference has not been knowing more. It has been making sure the important new evidence reliably reaches me.

The shortcut I actually use

I could tell you to build the habit yourself — pick your slot, watch the five leading palliative journals, triage the new issues, and read what matters. It works. It also takes a discipline that a busy on-call week tends to erode, which is exactly why my own attempts kept failing.

So I built the thing I wished existed, and now use it myself. The Monday Clinical Brief is, every Monday, every new paper from the field's leading journals — Palliative Medicine, the Journal of Pain and Symptom Management, BMJ Supportive & Palliative Care, the Journal of Palliative Medicine and Supportive Care in Cancer — summarised in plain language and formatted for CPD.

It removes the one thing that kept breaking my habit: the weekly decision. The summaries are enough on their own most weeks, and each one is written to drop straight into a reflection. And because reading and reflecting on the evidence is some of the most defensible CPD there is, the same twenty minutes does double duty at appraisal — our guides on logging journal reading for GMC revalidation, the CPD reflection template, and using AI for reflection within the rules cover how to make it count.

You can read a free sample issue before deciding whether it saves you the twenty minutes. There is a four-week free trial, and after that it is £20 a year — less than the time it costs to keep meaning to catch up. If you want the wider version of this argument beyond palliative care, our pillar guide on keeping up with the medical literature sets it out in full.

Three things to take away

1. Keeping up and looking up are different jobs. Search answers the questions you bring it; it cannot tell you what you should have read.
2. A small, fixed, repeatable slot beats the heroic catch-up that never happens. Remove the weekly decision and the habit survives.
3. Permission to read the summary and stop is what makes it sustainable. Depth on demand, breadth on schedule.

However you do it — a manual skim or a digest that does the skimming for you — the habit is what keeps you current. The reading is the point. The routine just makes sure it happens.