Are patients who enter hospice care really abandoned by their primary care doctors?

A recent study on hospice care has been making mainstream media headlines, and, of course, doctors are cast in a negative light.

The study, from the Archives of Internal Medicine, concluded that patients felt abandoned by their primary care doctors upon transfer to hospice care, and that the “feelings of abandonment resulted from lack of closure for patients and families.”

Palliative care physician Christian Sinclair gives his take on the study, and writes that the rift caused from abandonment can be smoothed by clearly communicating the expectations of what hospice care is.

Most community doctors are not formally trained in end-of-life care, and feel more comfortable asking for the help of palliative care professionals. That choice, however, is ultimately the patient’s, and indeed, “the patient has the right to choose the physician of record. Hospice should be about choice.”

Furthermore, the physician payment system does not value, nor reimburse, phone calls to patients on hospice services, and thus, harried doctors appear to sever ties with hospice patients. Dr. Sinclair notes that “efficient offices can manage to maintain contact during and after the hospice period,” and that, “it takes a more systematic approach,” such as a phone call every two weeks by an office staff member.

So, yes, there are ways to decrease the feeling of abandonment. But doctors need to realize that this feeling exists first, and next, come up with formal systems to maintain some kind of contact with patients in hospice.

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