Related Experiment Videos
Physicians' Views on Advance Care Planning and End-of-Life Care Conversations
Terry Fulmer1, Marcus Escobedo1, Amy Berman1
1John A. Hartford Foundation, New York, NY.
Journal of the American Geriatrics Society
|May 26, 2018
Summary
Most physicians value end-of-life conversations but lack formal training, citing time as a major barrier. Enhancing medical education and addressing clinician barriers are crucial for effective advance care planning.
Area of Science:
- Medical Education
- Geriatrics
- Palliative Care
Background:
- Advance care planning (ACP) is crucial for aligning patient preferences with medical treatment.
- Physician perspectives on ACP and end-of-life (EOL) discussions are vital for improving care quality.
- Understanding barriers and facilitators to EOL conversations can inform practice and policy.
Purpose of the Study:
- To evaluate physicians' views on advance care planning, goals of care, and end-of-life conversations.
- To identify perceived barriers and facilitators to conducting these important discussions.
- To assess physician support for policies aimed at improving ACP.
Main Methods:
- A random sample telephone survey was conducted with 736 physicians in the United States.
- Participants included primary care and subspecialists (pulmonology, cardiology, oncology) seeing older adults.
- A 37-item survey assessed attitudes, barriers, and facilitators related to ACP.
Main Results:
- 99% of physicians believe EOL conversations are important, but only 29% have formal training.
- Physician-reported barriers include time constraints, discomfort, and fear of diminishing patient hope.
- Patient values (92%) are a strong motivator; 95% support Medicare reimbursement for ACP.
Conclusions:
- Medical school curricula require strengthening to prepare physicians for EOL conversations.
- Addressing clinician-reported barriers is essential to meet the needs of older adults and their families.
- Payment policies for quality care, including ACP, need regular evaluation.