However, our biggest takeaway from the conversation is the need for providers to begin care planning long before end of life. Regardless of age, sex, or condition, providers should be asking their patients one question: What are your goals for your care experience?
In order to improve care for patients, providers must understand each patient's goals
Dr. Gawande says we should be initiating care planning conversations with any patient who has a non-curable condition, at any stage of life—not just at the end of life. Why? Because learning what patients want helps providers to deliver care that improves wellness and quality of life, even when an absolute cure isn't possible.
In our conversations with physician leaders, we often hear how frustrating it can be to treat a patient who has a non-curable condition. Physicians are trained to want to solve all our problems, and often feel powerless when they can't "fix" a patient.
But "fixing" doesn't necessarily mean curing. Fixing can be helping patients achieve their care goals within the health constraints they face, such as helping them feel physically better or do more of the simple things that bring meaning to their lives, like watching football and eating ice cream. Dr. Gawande says these improvements are "incredible victories" in and of themselves—but these gains cannot be realized until physicians engage their patients in honest conversations about their care goals.