June 2, 2014
Doctors choose different end of life strategies for themselves and for patients
New American Media - A new study questions whether doctors providing end-of-life care are “prolonging life, or are we prolonging the dying process,” said lead researcher V.J. Periyakoil, MD, who directs Stanford Medical School’s Palliative Care Education and Training program.
The study, titled “Do Unto Others,” reveals that even though an overwhelming majority of physicians Stanford surveyed (88.3 percent) would reject unnecessarily invasive treatment for themselves and opt instead for comfort care, patients in the United States continue to spend their last days receiving high-intensity care that is often ineffective and sometimes ordered contrary to patients’ wishes.
The nearly 1,100 doctors who participated—over half of them women physicians and nearly half of them from immigrant and minority communities—were also highly supportive of patients filling out advance directives that state whether they’d prefer intensive treatment or palliative comfort care, if they become incapacitated at life’s end.
Doctors, patients want the same care
The Stanford study, published last week in the respected journal PLOS One, cites research showing that most Americans want the same care doctors do for themselves: “More than 80 percent of patients say that they wish to avoid hospitalizations and high-intensity care at the end-of-life, but their wishes are often overridden.”
Despite that knowledge, says the Stanford report, high-tech treatments have increased dramatically in recent years. Medical data show a 12 percent jump just from 2003 to 2007, in the number of Medicare patients who saw 10 or more doctors in their last six months of life—mainly medical specialists—and spent more days in intensive care units.
Not only is most high-tech care unwanted, says the Stanford study; it’s enormously costly. Medicare spends a quarter of its budget on services in the last year of life. And 40 percent of that expense is on patients within the last 30 days of life. http://prorevnews.blogspot.com/2014/06/doctors-choose-different-end-of-life.html