Why your patients need advance care plans

(Via Medical Economics) End-of-life care discussions with patients are critical for physicians of any specialty, but especially primary care.

Truth be told, we physicians have traditionally and by design avoided end-of-life care discussions with our patients. For some of us, such discussions are simply too difficult or uncomfortable to have. For others, despite the illness, age, or medical truth of a patient’s condition, addressing the reality of death and dying has wrongfully been considered a medical failure of sorts. Because of this hesitancy, we almost always turn to providing more “care” and often keep patients alive through extraordinary means – including sometimes heroic measures – even though we know the outcome won’t change. Not only is money spent in these efforts but often this “care” is not even what the patient wants as they consider time of life vs. quality of life.

If you think this is a topic only for oncologists or gerontologists, think again. It’s for all of us who have patient contact, regardless of specialty. It is especially germane for primary care physicians who over time build a trusting relationship with their patients with a common understanding of the patient’s prognosis and state-of-mind. A 2010 study from Johns Hopkins revealed that when people were given choices of where to get advance care planning advice, they overwhelmingly chose physicians. Despite that, we don’t initiate those conversations often enough, and patients are reluctant to do so themselves when a standard primary care visit is only about 15-20 minutes. Read on…