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Doctors don't know how

dog in chairI stumbled onto an article about advance care planning…I know…dry dry dry. Occupational hazard. But bear with me; this applies to you, I promise. There were two main articles referenced. The first was from the Chicago Tribune: “Doctors slow to have end-of-life conversations.” The second was by MedPage Today: “End-of-Life talks: vital but not happening.” It verified what we’ve been saying:

"Virtually all physicians surveyed agree that talking with patients about end-of-life and advance care planning is important, and they overwhelmingly support a new Medicare benefit that reimburses them for having those discussions. The survey also identified barriers that keep physicians from engaging in these sensitive conversations, with nearly half (46%) reporting that they frequently or sometimes feel unsure of what to say, and less than one-third (29%) reporting having had any formal training specifically on talking with patients and their families about end-of-life care (The John A. Hart Foundation, 2016)."
 
Well, that’s a little startling. 71% of doctors had no formal education on talking about death. Something that is going to happen to every single person on earth. No training. Bah!
 
A list of "Media Coverage" articles posted links to nearly 50 newspapers, magazines, and journals. They included the AP, Boston Globe, Forbes, Reuters, and The Atlantic. Every link stressed the importance of end-of-life conversations. Many suggested a resource that can help. But none of them give you the basic medical information so you can make an educated decision. We do more research when we buy a car than we do about the options for our own bodies!
 
Google is handy but is it accurate? Will you understand the words? Medicine is a foreign language to most people. How do you know if you want to be on a ventilator or have a feeding tube? Can you sit in your doctor’s office exam room and learn about CPR outcomes or how dialysis works? Doctors are now reimbursed for talking with patients about end-of-life. But, is your doctor offering to have a conversation in a relaxed environment over snacks and beverages? Probably not.
 
Do you want to?
 
You need to have the conversation. And you can find resources with lists of questions to ask or ideas on how to start the conversation. And you know you need to document your wishes.

But before you do any of that, you need to have a foundation of information so you can make educated decisions. The experience we have created with Sips & Wishes is different. You can sit in a comfy chair and have a conversation with a nurse. The interactive presentation covers four main topics: ventilators, CPR, dialysis, and feeding tubes. Then we talk about the importance of letting your loved ones know your wishes. If you don't tell them and you are suddenly unable to be your own advocate, they will have to guess.
 
The research shows most doctors find it hard to talk with patients about end-of-life. Not because they lack empathy or don’t have that bone in their body. Their formal medical training looks at death as a failure instead of something that will happen to everybody. They don’t have a class in med school that teaches them to have these conversations. But Erin and I are comfortable having these conversations. We understand the medical stuff and can help you think about what’s important to you. Because identifying your priorities in life helps you make decisions about death. We help with the conversation. We’re your guide. You’ll be the hero in your own story.

https://www.johnahartford.org/dissemination-center/view/advance-care-planning-poll
 
Fun fact: Since death and taxes are life’s two guarantees, April 16 (the day after taxes are usually due) is National Healthcare Decisions Day. People are encouraged to make decisions about their end-of-life care wishes. Use this date as a reminder to make an appointment with Sips & Wishes and to explore options for your Advanced Directives. There are online tools or local estate attorneys to help.
 
https://www.aarp.org/caregiving/financial-legal/free-printable-advance-directives/