Concerns and self-reported competencies in end-of-life care: a survey of physicians in WV

To assess concerns and self-reported competencies in end-of-life (EOL) care, we surveyed a random sample of West Virginia physicians and received 255 responses (33%). Those responding identified three major barriers to good EOL care: patient and family demands for all possible treatments, lack of physician education and inadequate financing. Most identified themselves as less than informed about EOL legislative and regulatory issues and were less than satisfied with their EOL symptom management skills. Most reported that their patients would want hospice care at the end of their lives, but indicated that a major reason for not referring a patient to hospice was patient and family denial of approaching death. Most respondents rated the overall quality of EOL care in West Virginia as fair to poor. We conclude that physician respondents recognize the need to improve their knowledge and skills in EOL care to improve the care of the dying in West Virginia.