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Steering Committee

GPCQA Steering Committee


Janet Bull, MD is the Chief Medical Officer at Four Seasons. She is committed to providing compassionate, quality care and oversees the medical needs of patients at Four Seasons. She believes in the "whole patient care" model embracing the physical, psychosocial, and spiritual needs of patients.

Janet grew up in Miami, Florida. She attended Southern Methodist University in Dallas, Texas, graduating with a BS in Biology. She earned her MD degree at Southwestern University in Dallas, and completed a residency in Obstetrics-Gynecology at the University of Alabama in Birmingham. In 1985, she entered private practice in Atlanta, Georgia. She received her board certifications in both Obstetrics-Gynecology and Endoscopy Surgery.

In 2000, she joined Four Seasons. She was instrumental in starting the Palliative Care program in 2003, and in 2005, she founded the Clinical Research department in an attempt to bring meaningful studies to help lessen suffering to patients.

Janet holds a consultant assistant professorship in the internal medicine department at Duke University Medical Center and is a clinical instructor in Medicine at UNC- CH Henderson Family Practice Residency Program. She is a Fellow of the American Academy of Hospice and Palliative Medicine (AAHPM), board certified in hospice and palliative medicine and a frequent speaker at both state and national meetings.

Janet has been an Associate Editor of PC-FACS since 2008, and has authored or coauthored several papers on palliative care and quality data reporting. She directs the research department at Four Seasons and has served as the Principle Investigator on over 41 clinical trials in hospice and palliative medicine. She is Program Director of the Palliative Care Immersion Course and directs Four Seasons’ Center of Excellence which offers consulting services in hospice, palliative care, and research. She was the recipient of the Sharon O. Dixon Award in 2007, the Cuniff-Dixon Hastings Award in 2012, and the Josephino Magno Distinguished Physician Award in 2013. Most recently, she was named one of the Top 25 Visionaries in the Field award by the American Academy of Hospice and Palliative Medicine.


Arif Kamal M.D is an Assistant Professor of Medicine in the Division of Medical Oncology and Duke Palliative Care at Duke University Medical Center.  He is also the Physician Director of Quality and Outcomes for the Duke Cancer Institute (DCI). As a board-certified palliative medicine physician and medical oncologist, Dr. Kamal studies the link between delivery of high quality care and improved patient, caregiver, and health system outcomes.
Dr. Kamal graduated summa cum laude with a Bachelors of Liberal Arts and Doctorate of Medicine degrees within the combined 6-year program at the University of Missouri – Kansas City.  Subsequently, he completed Internal Medicine residency and Hospice and Palliative Medicine fellowship at the Mayo Clinic – Rochester, MN and Hematology/Oncology fellowship at Duke University.  He recently completed a Masters in Health Sciences in Clinical Research from the Duke Clinical Research Training Program and is currently pursuing a Masters in Business Administration from the University of Massachusetts – Amherst.


Diane Portman, MD, FAAHPM is the Chair of the Supportive Care Medicine Department at Moffitt Cancer Center, including the Divisions of Palliative Medicine, Behavioral Medicine and Integrative Medicine.  She is an Assistant Professor in the Department of Oncologic Sciences at the University of South Florida.

Dr. Portman, an Anesthesiologist and credentialed Pain Management physician, earlier served as a Medical Director for a large Florida hospice organization for 6 years.  Her interests in Cancer pain and symptom control, teaching the next generation of Palliative Care clinicians and fostering Palliative Care throughout the cancer care continuum for oncology patients led to her recruitment to Moffitt Cancer Center, an NCI designated tertiary cancer center, in early 2012.   There, she has overseen significant Moffitt Supportive Care Medicine department expansion in staff and services, and led the reconfiguration and rebranding of department offerings in accordance with quality national standards for Supportive Care in Oncology.  This led to Moffitt achieving Advanced Certification in Palliative Care by The Joint Commission in 2014.

Dr. Portman received her MD degree at Jefferson Medical College and completed an Anesthesia Residency at the Hospital of the University of Pennsylvania.  She is board certified in Anesthesiology, Hospice and Palliative Medicine, and is a fellow in the Academy of Hospice and Palliative Medicine.  She represents Moffitt on the NCCN Palliative Care Panel and is a frequent speaker and advocate in Palliative Care matters nationally and internationally.

Dr. Portman’s clinical interests include the therapy of cancer-related pain and other symptoms, palliative communications and shared decision making and their integration into the comprehensive supportive care model. Her research interests include service models, outcomes and quality assessment of Palliative Care. She has an ardent interest in the integration of Palliative care in Oncologic services and has been a fervent promoter of the advancement of the field of Palliative Medicine overall.


Christine Ritchie, MD, MSPH, FACP, FAAHPM is the Harris Fishbon Distinguished Professor in Clinical Translational Research and Aging. She is a board certified geriatrician and palliative care physician with long-standing experience in clinical care delivery and advanced illness research. Dr. Ritchie has overseen the development of a number of comprehensive clinical programs for seriously ill older adults, most recently at the University of Alabama at Birmingham (UAB) where she directed the Center for Palliative and Supportive Care. At UCSF, Dr. Ritchie serves as medical director of Clinical Programs in the Office of Population Health. She is also working with other colleagues to facilitate the growth of clinical programs and research that focus on quality of life and health care delivery models for those with chronic serious illness and multimorbidity. She directs Tidsewell at UCSF ( and co-leads a national Network of Home-based primary care and palliative care practices and is working to develop quality measures that are appropriate to the homebound population. She is President of the American Academy of Hospice and Palliative Medicine.


Dr. Jacob Strand is Assistant Professor of Medicine at the Mayo Clinic College of Medicine in Rochester, Minnesota. Dr. Strand received his M.D. from the Mayo Clinic College of Medicine and subsequently completed his residency training in internal medicine at Brigham and Women’s Hospital in Boston, Massachusetts. He remained in Boston for palliative medicine training at the Harvard Palliative Medicine Fellowship Program.
Dr. Strand is the Chief of Palliative Medicine Services Mayo Clinic and the Medical Director of the Symptom Management, Pain and Quality of Life Clinic in Rochester, MN.  Dr. Strand’s research and educational interests center around the integration of palliative medicine and anesthesia pain disciplines, management of complex cancer-related pain and barriers to cancer pain management.  He participates in several active national research protocols and lectures nationally and internationally on these topics.

Joan Teno

Joan M. Teno, M.D., M.S. is a Professor of Health Services, Policy, and Practice and Associate Director of the Center for Gerontology and Health Care Research at the Brown University School of Public Health and Brown Medical School. She is a health services researcher, former  hospice medical director, and board-certified internist with added qualification in Geriatrics and Palliative Medicine. Dr. Teno has served on numerous advisory panels including the Institute of Medicine, World Health Organization and American Bar Association and as grant peer reviewer for the National Institutes of Health. She has been the recipient of funding from the National Institute of Health (NIH) and the Robert Wood Johnson Foundation. Dr. Teno's focus has been on measuring and evaluating interventions to improve the quality of medical care for seriously ill and dying patients. Dr. Teno led the effort in the design of the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) intervention analysis and was lead author in twelve publications from that research effort, which ranged from the role of advance directives to describing the dying experience of seriously ill and older adults. Both as a researcher and clinician, Dr. Teno has devoted her career to understanding how to measure and improve the quality of end of life care for vulnerable populations. She was the lead investigator in a research effort to create a Toolkit of Instruments to Measure Care at the End of Life (TIME). In this grant effort, she created the Brown University Family Evaluation of Hospice Care, that is currently being used by hospice across the nation and internationally to examine the quality of hospice care. She has led a state wide effort to improve pain management in nursing homes, for which she has received an award from the American Cancer Society. Over 180 research articles have been published in leading medical journals focusing on examining medical care for dying persons and frail persons residing in nursing homes.

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