End of life conversations and decisions seem to start with some health event that marks the transition to this new phase of life. Doctors are at the center of those health conversations, but our healthcare system doesn't provide the right support for end of life conversations. This article and survey, Doctors Unsure About How To Talk With Patients About End-Of-Life Care, highlights the need for incentives (to compensate for a doctor's time), training, and new norms in healthcare. A few highlights:
- Medicare now reimburses doctors $86 to discuss end-of-life care in an office visit that covers topics such as hospice, living wills and do-not-resuscitate orders. Known as "advance care planning," the conversations can also be held in a hospital.
- While 75 percent of doctors said Medicare reimbursement makes it more likely they'd have advance care planning discussions, only about 14 percent said they had actually billed Medicare for those visits.
- Three quarters also believe it's their responsibility to initiate end-of-life conversations.
- Fewer than one-third reported any formal training on end-of-life discussions with patients and their families.
- More than half said they had not discussed end-of-life care with their own physicians.