Starting this year, Medicare will cover all end-of-life conversations, not just for patients who are new enrollees, and some private insurers are following suit.
The conversations about how patients want to die, where they want to die, whether they would want doctors to take all possible measures to keep them alive — or whether they prefer to forgo intensive medical treatments to be more comfortable at the end – are tough to have for both patients and doctors.
Last year, in advance of the new policies taking effect, some medical experts and patient advocacy organizations questioned how prepared doctors are to have these conversations.
In a Forbes article from December, Dr. Susan Block, director of Serious Illness Care Program at Ariadne Labs, a collaboration of Brigham and Women’s Hospital and the Harvard School of Public Health, said, “This particular kind of conversation is at the intersection of two topics that medical schools have by and large avoided – end-of-life care and communication.”
We wanted to see how prepared SERMO doctors feel to have the conversations so we ran a poll of the community. The results were mixed. Our poll found that 56 percent of U.S. physicians believe they would benefit from training on end-of-life discussions (1,499 physicians participated in this poll).
One physical medicine and rehabilitation specialist said, “I think we could use training in eldercare/systems of service, POA, guardianship and competency. I know I was clueless about it all when I had to face it with my mom and dad. We also need to know realistic possibilities in terms of quality of life and life expectancies with various conditions and disabilities – as a profession, we are WAY off the mark as more often than I’d like to see.”
An obstetrician and gynecologist added that preparedness, “Comes with experience and the type of patients you deal with. A course won’t teach us this, but it can make us more aware of all the issues that are involved.”
What do you think? Do doctors need more training on the topic? Comment here, or if you’re a doctor join the conversation on SERMO, where we’re discussing this and a myriad of other hot topics.