Advance Care Planning Conversations in the Oncology Setting: Tips from the Experts

Advance care planning (ACP) has been identified as a fundamental part of every patient's total health care plan and is actively supported by a number of health care organizations. Despite these endorsements, however, having advance care planning conversations has not come easily for physicians. Training future physicians should include practical ways to address this issue. Fifty physicians at an oncology hospital, who were identified as having the most ACP conversations, were approached. Twenty-six percent participated in a survey which was sent out electronically via Qualitrics. All answers were recorded online and responses were collected and analyzed according to thematic analysis methodology. Major themes were noted and summarized for each of the survey's 10 questions, resulting in how the physicians can successfully plan for and initiate advance care planning conversations with their patients and families. Themes touched upon self-awareness, one's outlook on the value of life, and the importance of death as part of the care continuum. A physician's own perception of the value of ACP conversations greatly influences them having those conversations. Furthermore, it is key that the physician understands and be aware of the patient's perspective regarding their cancer and how it impacts them. This dynamic will then allow the physician to better align their plan of care with the treatment goals and expectations of the patient. Future training programs should incorporate these suggestions.