Doctors find it difficult to talk about end-of-life care to their patients, a new poll has found.
Surveys among doctors show that having end-of-life conversations and advance care planning are important for Medicare patients. However, in a new poll from the John A. Hartford Foundation and Cambia Foundation, clinicians reported different hindrances in providing for such service.
In fact, almost 46 percent of doctors said that they are sometimes or oftentimes unsure of what to say during these meetings.
Advance care planning enables people to know their treatment options, decide on the care they want to receive and share those wishes with their family and loved ones. These wishes ideally go into writing and into the patient's electronic records. Such aspect of care aims to empower individuals by knowing that their decisions will be considered and respected.
Full Support, Partial Delivery
In 2015, a poll from the Kaiser Family Foundation showed that the public support advanced care planning.
So in January 2016, Medicare and Medicaid started reimbursing clinicians for providing advance care planning services, which entails having numerous meetings with patients, even if they are not yet in the midst of dying.
Although the new poll showed that 95 percent of doctors also support end-of-life care, only 14 percent said they have billed Medicare for such service.
Why Only A Few Doctors Are Able To Do It
The poll shows that 74 percent of doctors admitted to seeing patients who would most likely die within the year. About 75 percent said they believe that doctors and other members of the health care team should initiate advanced care planning, and not the patient. However, they also stated some barriers as to why they find it difficult to do so.
Only 29 percent said that their education included formal courses for evaluating patients' end-of-life wishes. Less than 29 percent admitted the opposite.
Lastly, 24 percent said that the electronic health record does not have a portion for indicating if a patient received advance care planning. For those who do have it, only 54 percent said that they can actually look into its content.
Training Is A Big Factor
Training appears to be a notable factor in the outcome of the poll.
Doctors who had formal end-of-life care training were 46 percent more likely to find meaning and experience a rewarding feeling in meetings than those who had not.
About 60 percent of physicians who had training also reported to have rare or unusual experiences of not knowing what to say during meetings. This is higher than the 52 percent recorded for those who did not have explicit training.
Commitment To Patients
Another reason that halts doctors from talking about end-of-life care to patients is that they do not want to exude a sense of giving up. The majority of doctors said they do not want to make their patients feel like they are already giving up on them by talking about end-of-life goals.
"Reimbursing doctors to have these conversations is only part of the equation," says Cambia's Peggy Maguire.
The full report on the poll is published online on the John A. Hartford website.
