ABSTRACT
Hospices began with the mission of providing a superior service for a vulnerable population. The hospice movement has grown and matured, the need to improve access to hospice care has driven concerns financial viability, management efficiency, and acceptance by the mainstream medical community. Hospice and palliative care in the United States and effectively in all countries began through the efforts of volunteers. As volunteers are often people who also work, it is impossible for volunteers to be able to respond to all the needs of patients who depend on hospice for their care. In the developing world, community health care workers are a major part of palliative care delivery. Hospices tend to attract employees and volunteers who are very altruistic and demand a great deal of their leaders. The common dictatorial style of management found in the business world is not easily tolerated in a hospice program. The values of a hospice ought to be found in its leaders.
