Photo of James A. Tulsky,  MD

James A. Tulsky, MD

Dana-Farber Cancer Institute

Dana-Farber Cancer Institute
Phone: (617) 582-9201
Fax: (617) 632-6180


jamesa_tulsky@dfci.harvard.edu

James A. Tulsky, MD

Dana-Farber Cancer Institute

EDUCATIONAL TITLES

  • Professor, Medicine, Harvard Medical School
  • Chair, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute
  • Chief, Division of Palliative Medicine, Medicine, Brigham And Women's Hospital

DF/HCC PROGRAM AFFILIATION

Research Abstract

Dr. Tulsky has a longstanding interest in doctor-patient communication and quality of life at the end of life, and has published widely in these areas. His current research focuses on the evaluation and enhancement of communication between oncologists and patients with advanced cancer, identification of clinical, psychosocial and spiritual trajectories of patients at the end of life, development of self-management interventions for patients with life-limiting illness, and evaluating the role of palliative care in congestive heart failure.

Publications

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  • Balboni MJ, Sullivan A, Smith PT, Zaidi D, Mitchell C, Tulsky JA, Sulmasy D, VanderWeele TJ, Balboni TA. The Views of Clergy Regarding Ethical Controversies in Care at the End of Life. J Pain Symptom Manage 2017. PubMed
  • Tulsky JA, Beach MC, Butow PN, Hickman SE, Mack JW, Morrison RS, Street RL, Sudore RL, White DB, Pollak KI. A Research Agenda for Communication Between Health Care Professionals and Patients Living With Serious Illness. JAMA Intern Med 2017. PubMed
  • Odejide OO, Cronin AM, Earle CC, Tulsky JA, Abel GA. Why are patients with blood cancers more likely to die without hospice? Cancer 2017. PubMed
  • Pollak KI, Back AL, Tulsky JA. Disseminating effective clinician communication techniques: Engaging clinicians to want to learn how to engage patients. Patient Educ Couns 2017. PubMed
  • Reese JB, Beach MC, Smith KC, Bantug ET, Casale KE, Porter LS, Bober SL, Tulsky JA, Daly MB, Lepore SJ. Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study. Support Care Cancer 2017. PubMed
  • Nelson JE, Hanson LC, Keller KL, Carson SS, Cox CE, Tulsky JA, White DB, Chai EJ, Weiss SP, Danis M. The Voice of Surrogate Decision Makers: Family Responses to Prognostic Information in Chronic Critical Illness. Am J Respir Crit Care Med 2017. PubMed
  • Bailey DE, Hendrix CC, Steinhauser KE, Stechuchak KM, Porter LS, Hudson J, Olsen MK, Muir A, Lowman S, DiMartini A, Salonen LW, Tulsky JA. Randomized trial of an uncertainty self-management telephone intervention for patients awaiting liver transplant. Patient Educ Couns 2017; 100:509-517. PubMed
  • Balboni MJ, Sullivan A, Enzinger AC, Smith PT, Mitchell C, Peteet JR, Tulsky J, VanderWeele T, Balboni TA. United States Clergy Religious Values and Relationships to End-of-Life Discussions and Care. J Pain Symptom Manage 2017. PubMed
  • Reese JB, Sorice K, Beach MC, Porter LS, Tulsky JA, Daly MB, Lepore SJ. Patient-provider communication about sexual concerns in cancer: a systematic review. J Cancer Surviv 2016. PubMed
  • Ouchi K, Block SD, Schonberg MA, Jamieson ES, Aaronson EL, Pallin DJ, Tulsky JA, Schuur JD. Feasibility Testing of an Emergency Department Screening Tool to Identify Older Adults Appropriate for Palliative Care Consultation. J Palliat Med 2016. PubMed
  • Odejide OO, Cronin AM, Condron NB, Fletcher SA, Earle CC, Tulsky JA, Abel GA. Barriers to Quality End-of-Life Care for Patients With Blood Cancers. J Clin Oncol 2016; 34:3126-32. PubMed
  • Carson SS, Cox CE, Wallenstein S, Hanson LC, Danis M, Tulsky JA, Chai E, Nelson JE. Effect of Palliative Care-Led Meetings for Families of Patients With Chronic Critical Illness: A Randomized Clinical Trial. JAMA 2016; 316:51-62. PubMed
  • Johnson KS, Payne R, Kuchibhatla MN, Tulsky JA. Are Hospice Admission Practices Associated with Hospice Enrollment for Older African Americans and Whites? J Pain Symptom Manage 2015. PubMed
  • Bodner ME, Bilheimer A, Gao X, Lyna P, Alexander SC, Dolor RJ, Østbye T, Bravender T, Tulsky JA, Graves S, Irons A, Pollak KI. Studying physician-adolescent patient communication in community-based practices: recruitment challenges and solutions. Int J Adolesc Med Health 2015. PubMed
  • Østbye T, Lyna P, Bodner ME, Alexander SC, Coffman C, Tulsky JA, Dolor R, Pollak K. The Effect of Parental Presence on Weight-Related Discussions Between Physicians and Their Overweight Adolescent Patients. Clin Pediatr (Phila) 2015. PubMed
  • Porter LS, Pollak KI, Farrell D, Cooper M, Arnold RM, Jeffreys AS, Tulsky JA. Development and implementation of an online program to improve how patients communicate emotional concerns to their oncology providers. Support Care Cancer 2015. PubMed
  • Zafar SY, Chino F, Ubel PA, Rushing C, Samsa G, Altomare I, Nicolla J, Schrag D, Tulsky JA, Abernethy AP, Peppercorn JM. The utility of cost discussions between patients with cancer and oncologists. Am J Manag Care 2015; 21:607-15. PubMed
  • Steinhauser KE, Voils CI, Bosworth H, Tulsky JA. What constitutes quality of family experience at the end of life? Perspectives from family members of patients who died in the hospital. 2015. PubMed
  • Tulsky JA. Decision Aids in Serious Illness: Moving What Works Into Practice. JAMA Intern Med 2015. PubMed
  • Hendrix CC, Bailey DE, Steinhauser KE, Olsen MK, Stechuchak KM, Lowman SG, Schwartz AJ, Riedel RF, Keefe FJ, Porter LS, Tulsky JA. Effects of enhanced caregiver training program on cancer caregiver's self-efficacy, preparedness, and psychological well-being. Support Care Cancer 2015. PubMed
  • Goldstein AO, Viera AJ, Pierson J, Barnhouse KK, Tulsky JA, Richman BD. Physician Beliefs about Physical and Mental Competency of Patients Applying for Concealed Weapon Permits. Behav Sci Law 2015. PubMed
  • Alexander SC, Fortenberry JD, Pollak KI, Østbye T, Bravender T, Tulsky JA, Dolor R, Shields CG. Disclosure of Sexual Intercourse by Teenagers: Agreement Between Telephone Survey Responses and Annual Visit Disclosures. Clin Pediatr (Phila) 2015. PubMed
  • Zafar SY, Ubel PA, Tulsky JA, Pollak KI. Cost-related health literacy: a key component of high-quality cancer care. J Oncol Pract 2015; 11:171-3. PubMed
  • Tulsky JA. Improving quality of care for serious illness: findings and recommendations of the Institute of Medicine report on dying in America. JAMA Intern Med 2015; 175:840-1. PubMed
  • Clay AS, Ross E, Chudgar SM, Grochowski CO, Tulsky JA, Shapiro D. The emotions of graduating medical students about prior patient care experiences. Patient Educ Couns 2015; 98:344-9. PubMed
  • Steinhauser KE, Voils CI, Bosworth HB, Tulsky JA. Validation of a measure of family experience of patients with serious illness: the QUAL-E (Fam). J Pain Symptom Manage 2014; 48:1168-81. PubMed
  • Mentz RJ, Tulsky JA, Granger BB, Anstrom KJ, Adams PA, Dodson GC, Fiuzat M, Johnson KS, Patel CB, Steinhauser KE, Taylor DH, O'Connor CM, Rogers JG. The palliative care in heart failure trial: rationale and design. Am Heart J 2014; 168:645-651.e1. PubMed
  • Pollak KI, Coffman CJ, Alexander SC, Østbye T, Lyna P, Tulsky JA, Bilheimer A, Dolor RJ, Lin PH, Bodner ME, Bravender T. Weight's up? Predictors of weight-related communication during primary care visits with overweight adolescents. Patient Educ Couns 2014; 96:327-32. PubMed
  • Sautter JM, Tulsky JA, Johnson KS, Olsen MK, Burton-Chase AM, Lindquist JH, Zimmerman S, Steinhauser KE. Caregiver experience during advanced chronic illness and last year of life. J Am Geriatr Soc 2014; 62:1082-90. PubMed
  • Zafar SY, Tulsky JA, Abernethy AP. It's time to have 'the talk': cost communication and patient-centered care. Oncology (Huntingt) 2014; 28:479-80. PubMed
  • Bravender T, Tulsky JA, Farrell D, Alexander SC, Østbye T, Lyna P, Dolor RJ, Coffman CJ, Bilheimer A, Lin PH, Pollak KI. Teen CHAT: Development and utilization of a web-based intervention to improve physician communication with adolescents about healthy weight. Patient Educ Couns 2013; 93:525-31. PubMed
  • Chhabra KR, Pollak KI, Lee SJ, Back AL, Goldman RE, Tulsky JA. Physician communication styles in initial consultations for hematological cancer. Patient Educ Couns 2013; 93:573-8. PubMed
  • Johnson KS, Kuchibhatla M, Payne R, Tulsky JA. Race and residence: intercounty variation in black-white differences in hospice use. J Pain Symptom Manage 2013; 46:681-90. PubMed
  • Lopez-Acevedo M, Havrilesky LJ, Broadwater G, Kamal AH, Abernethy AP, Berchuck A, Alvarez Secord A, Tulsky JA, Valea F, Lee PS. Timing of end-of-life care discussion with performance on end-of-life quality indicators in ovarian cancer. Gynecol Oncol 2013; 130:156-61. PubMed
  • Chiarchiaro J, Olsen MK, Steinhauser KE, Tulsky JA. Admission to the intensive care unit and well-being in patients with advanced chronic illness. Am. J. Crit. Care 2013; 22:223-31. PubMed
  • Schell JO, Green JA, Tulsky JA, Arnold RM. Communication skills training for dialysis decision-making and end-of-life care in nephrology. Clin J Am Soc Nephrol 2013; 8:675-80. PubMed
  • Barclay JS, Kuchibhatla M, Tulsky JA, Johnson KS. Association of hospice patients' income and care level with place of death. JAMA Intern Med 2013; 173:450-6. PubMed
  • Clayton JM, Butow PN, Waters A, Laidsaar-Powell RC, O'Brien A, Boyle F, Back AL, Arnold RM, Tulsky JA, Tattersall MH. Evaluation of a novel individualised communication-skills training intervention to improve doctors' confidence and skills in end-of-life communication. Palliat Med 2013; 27:236-43. PubMed
  • Morris DA, Johnson KS, Ammarell N, Arnold RM, Tulsky JA, Steinhauser KE. What is your understanding of your illness? A communication tool to explore patients' perspectives of living with advanced illness. J Gen Intern Med 2012; 27:1460-6. PubMed
  • Johnson KS, Elbert-Avila K, Kuchibhatla M, Tulsky JA. Characteristics and outcomes of hospice enrollees with dementia discharged alive. J Am Geriatr Soc 2012; 60:1638-44. PubMed
  • Burton AM, Sautter JM, Tulsky JA, Lindquist JH, Hays JC, Olsen MK, Zimmerman SI, Steinhauser KE. Burden and well-being among a diverse sample of cancer, congestive heart failure, and chronic obstructive pulmonary disease caregivers. J Pain Symptom Manage 2012; 44:410-20. PubMed
  • Cox CE, Porter LS, Hough CL, White DB, Kahn JM, Carson SS, Tulsky JA, Keefe FJ. Development and preliminary evaluation of a telephone-based coping skills training intervention for survivors of acute lung injury and their informal caregivers. Intensive Care Med 2012; 38:1289-97. PubMed
  • Cox CE, Lewis CL, Hanson LC, Hough CL, Kahn JM, White DB, Song MK, Tulsky JA, Carson SS. Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation. Crit Care Med 2012; 40:2327-34. PubMed
  • Alexander SC, Sullivan AM, Back AL, Tulsky JA, Goldman RE, Block SD, Stewart SK, Wilson-Genderson M, Lee SJ. Information giving and receiving in hematological malignancy consultations. 2012. PubMed
  • Tulsky JA, Arnold RM, Alexander SC, Olsen MK, Jeffreys AS, Rodriguez KL, Skinner CS, Farrell D, Abernethy AP, Pollak KI. Enhancing communication between oncologists and patients with a computer-based training program: a randomized trial. Ann Intern Med 2011; 155:593-601. PubMed
  • Rodriguez KL, Bayliss NK, Alexander SC, Jeffreys AS, Olsen MK, Pollak KI, Garrigues SK, Tulsky JA, Arnold RM. Effect of patient and patient-oncologist relationship characteristics on communication about health-related quality of life. 2012; 20:935-42. PubMed
  • Steinhauser KE, Arnold RM, Olsen MK, Lindquist J, Hays J, Wood LL, Burton AM, Tulsky JA. Comparing three life-limiting diseases: does diagnosis matter or is sick, sick? J Pain Symptom Manage 2011; 42:331-41. PubMed
  • Johnson KS, Tulsky JA, Hays JC, Arnold RM, Olsen MK, Lindquist JH, Steinhauser KE. Which domains of spirituality are associated with anxiety and depression in patients with advanced illness? J Gen Intern Med 2011; 26:751-8. PubMed
  • Johnson KS, Kuchibhatla M, Tulsky JA. Racial differences in location before hospice enrollment and association with hospice length of stay. J Am Geriatr Soc 2011; 59:732-7. PubMed
  • Anderson WG, Chase R, Pantilat SZ, Tulsky JA, Auerbach AD. Code status discussions between attending hospitalist physicians and medical patients at hospital admission. J Gen Intern Med 2011; 26:359-66. PubMed
  • Bailey DE, Steinhauser K, Hendrix C, Tulsky JA. Pairing Self-Management with Palliative Care: Intervening in Life-Limiting Illness. 2011; 3:1-3. PubMed
  • Alexander SC, Pollak KI, Morgan PA, Strand J, Abernethy AP, Jeffreys AS, Arnold RM, Olsen M, Rodriguez KL, Garrigues SK, Manusov JR, Tulsky JA. How do non-physician clinicians respond to advanced cancer patients' negative expressions of emotions? Support Care Cancer 2011; 19:155-9. PubMed
  • Pollak KI, Arnold R, Alexander SC, Jeffreys AS, Olsen MK, Abernethy AP, Rodriguez KL, Tulsky JA. Do patient attributes predict oncologist empathic responses and patient perceptions of empathy? Support Care Cancer 2010; 18:1405-11. PubMed
  • Back AL, Arnold RM, Baile WF, Edwards KA, Tulsky JA. When praise is worth considering in a difficult conversation. Lancet 2010; 376:866-7. PubMed
  • Abernethy AP, McDonald CF, Frith PA, Clark K, Herndon JE, Marcello J, Young IH, Bull J, Wilcock A, Booth S, Wheeler JL, Tulsky JA, Crockett AJ, Currow DC. Effect of palliative oxygen versus room air in relief of breathlessness in patients with refractory dyspnoea: a double-blind, randomised controlled trial. Lancet 2010; 376:784-93. PubMed
  • Unroe M, Kahn JM, Carson SS, Govert JA, Martinu T, Sathy SJ, Clay AS, Chia J, Gray A, Tulsky JA, Cox CE. One-year trajectories of care and resource utilization for recipients of prolonged mechanical ventilation: a cohort study. Ann Intern Med 2010; 153:167-75. PubMed
  • Rodriguez KL, Bayliss N, Alexander SC, Jeffreys AS, Olsen MK, Pollak KI, Kennifer SL, Tulsky JA, Arnold RM. How oncologists and their patients with advanced cancer communicate about health-related quality of life. 2010; 19:490-9. PubMed
  • Steinhauser KE, Alexander SC, Byock IR, George LK, Tulsky JA. Seriously ill patients' discussions of preparation and life completion: an intervention to assist with transition at the end of life. 2009; 7:393-404. PubMed
  • Cox CE, Martinu T, Sathy SJ, Clay AS, Chia J, Gray AL, Olsen MK, Govert JA, Carson SS, Tulsky JA. Expectations and outcomes of prolonged mechanical ventilation. Crit Care Med 2009; 37:2888-94; quiz 2904. PubMed
  • Skinner CS, Pollak KI, Farrell D, Olsen MK, Jeffreys AS, Tulsky JA. Use of and reactions to a tailored CD-ROM designed to enhance oncologist-patient communication: the SCOPE trial intervention. Patient Educ Couns 2009; 77:90-6. PubMed
  • Kennifer SL, Alexander SC, Pollak KI, Jeffreys AS, Olsen MK, Rodriguez KL, Arnold RM, Tulsky JA. Negative emotions in cancer care: do oncologists' responses depend on severity and type of emotion? Patient Educ Couns 2009; 76:51-6. PubMed
  • Back AL, Arnold RM, Baile WF, Tulsky JA, Barley GE, Pea RD, Fryer-Edwards KA. Faculty development to change the paradigm of communication skills teaching in oncology. J Clin Oncol 2009; 27:1137-41. PubMed
  • Steinhauser KE, Alexander SC, Byock IR, George LK, Olsen MK, Tulsky JA. Do preparation and life completion discussions improve functioning and quality of life in seriously ill patients? Pilot randomized control trial. J Palliat Med 2008; 11:1234-40. PubMed
  • Robinson TM, Alexander SC, Hays M, Jeffreys AS, Olsen MK, Rodriguez KL, Pollak KI, Abernethy AP, Arnold R, Tulsky JA. Patient-oncologist communication in advanced cancer: predictors of patient perception of prognosis. Support Care Cancer 2008; 16:1049-57. PubMed
  • Anderson WG, Alexander SC, Rodriguez KL, Jeffreys AS, Olsen MK, Pollak KI, Tulsky JA, Arnold RM. "What concerns me is..." Expression of emotion by advanced cancer patients during outpatient visits. Support Care Cancer 2008; 16:803-11. PubMed
  • Allen LA, Yager JE, Funk MJ, Levy WC, Tulsky JA, Bowers MT, Dodson GC, O'Connor CM, Felker GM. Discordance between patient-predicted and model-predicted life expectancy among ambulatory patients with heart failure. JAMA 2008; 299:2533-42. PubMed
  • Pollak KI, Arnold RM, Jeffreys AS, Alexander SC, Olsen MK, Abernethy AP, Sugg Skinner C, Rodriguez KL, Tulsky JA. Oncologist communication about emotion during visits with patients with advanced cancer. J Clin Oncol 2007; 25:5748-52. PubMed
  • Taylor DH, Ostermann J, Van Houtven CH, Tulsky JA, Steinhauser K. What length of hospice use maximizes reduction in medical expenditures near death in the US Medicare program? Soc Sci Med 2007; 65:1466-78. PubMed
  • Back AL, Arnold RM, Baile WF, Fryer-Edwards KA, Alexander SC, Barley GE, Gooley TA, Tulsky JA. Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. Arch Intern Med 2007; 167:453-60. PubMed
  • Keitz SA, Stechuchak KM, Grambow SC, Koropchak CM, Tulsky JA. Behind closed doors: management of patient expectations in primary care practices. Arch Intern Med 2007; 167:445-52. PubMed
  • Koropchak CM, Pollak KI, Arnold RM, Alexander SC, Skinner CS, Olsen MK, Jeffreys AS, Rodriguez KL, Abernethy AP, Tulsky JA. Studying communication in oncologist-patient encounters: the SCOPE Trial. Palliat Med 2006; 20:813-9. PubMed
  • Steinhauser KE, Clipp EC, Hays JC, Olsen M, Arnold R, Christakis NA, Lindquist JH, Tulsky JA. Identifying, recruiting, and retaining seriously-ill patients and their caregivers in longitudinal research. Palliat Med 2006; 20:745-54. PubMed
  • Alexander SC, Keitz SA, Sloane R, Tulsky JA. A controlled trial of a short course to improve residents' communication with patients at the end of life. Acad Med 2006; 81:1008-12. PubMed
  • Steinhauser KE, Voils CI, Clipp EC, Bosworth HB, Christakis NA, Tulsky JA. "Are you at peace?": one item to probe spiritual concerns at the end of life. Arch Intern Med 2006; 166:101-5. PubMed
  • Tulsky JA. Beyond advance directives: importance of communication skills at the end of life. JAMA 2005; 294:359-65. PubMed
  • Back AL, Arnold RM, Tulsky JA, Baile WF, Fryer-Edwards KA. On saying goodbye: acknowledging the end of the patient-physician relationship with patients who are near death. Ann Intern Med 2005; 142:682-5. PubMed
  • Johnson KS, Elbert-Avila KI, Tulsky JA. The influence of spiritual beliefs and practices on the treatment preferences of African Americans: a review of the literature. J Am Geriatr Soc 2005; 53:711-9. PubMed
  • Steinhauser KE, Clipp EC, Bosworth HB, McNeilly M, Christakis NA, Voils CI, Tulsky JA. Measuring quality of life at the end of life: validation of the QUAL-E. 2006; 2:3-14. PubMed
  • Back AL, Arnold RM, Tulsky JA, Baile WF, Fryer-Edwards KA. Teaching communication skills to medical oncology fellows. J Clin Oncol 2003; 21:2433-6. PubMed
  • Lo B, Kates LW, Ruston D, Arnold RM, Cohen CB, Puchalski CM, Pantilat SZ, Rabow MW, Schreiber RS, Tulsky JA. Responding to requests regarding prayer and religious ceremonies by patients near the end of life and their families. J Palliat Med 2003; 6:409-15. PubMed
  • Lo B, Ruston D, Kates LW, Arnold RM, Cohen CB, Faber-Langendoen K, Pantilat SZ, Puchalski CM, Quill TR, Rabow MW, Schreiber S, Sulmasy DP, Tulsky JA, . Discussing religious and spiritual issues at the end of life: a practical guide for physicians. JAMA 2002; 287:749-54. PubMed
  • Adams JA, Anderson RA, Docherty SL, Tulsky JA, Steinhauser KE, Bailey DE. Nursing strategies to support family members of ICU patients at high risk of dying. 2014; 43:406-15. PubMed
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