Physicians want to expand end-of-life care

Poll: Most physicians support care once mischaracterized as 'death panels'

Nearly all physicians support efforts that focus on quality of life for dying patients over extending their lives for as long as possible, according to a poll released on Tuesday.

The issue of end-of-life care came up during the federal health reform law debate, when opponents of the overhaul mischaracterized a provision that would have reimbursed physicians for end-of-life care consultations as "death panels." The provision ultimately was left out of the final reform law.

The poll of 500 board-certified physicians—which was conducted by the Regence Foundation on behalf of National Journal—found that 96% of respondents emphasize quality of life over length of life for dying patients, and a similar majority said the U.S. health system should prioritize palliative care services.

A National Journal poll conducted in February asked the same question to the public and found that 71% agreed with physicians. However, 79% of physicians said the U.S. spends too much on trying to keep patients alive, while only 37% of the public held a similar belief.

The poll identified several barriers to palliative care efforts. Nearly 25% of physicians said they were uncomfortable discussing end-of-life options with patients and 24% said they were unprepared to do so. A similar number of physicians said they resisted bringing up palliative care with patients to avoid appearing as if they had given up. Eighty-two percent cited reimbursement as a barrier, with 95% calling for private insurance coverage and 94% supporting Medicare coverage for palliative care (Sanger-Katz, National Journal, 11/15 [subscription required]; Baker, "Healthwatch," The Hill, 11/15).

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