Doctors having hard time engaging with patients on end of life discussions

According to a national poll released Thursday survey by The John A. Hartford Foundation, the California Health Care Foundation and Cambia Health Foundation, doctors are having a difficult time starting end of life discussions and, when they do, aren't sure what to say.

Such discussions are becoming more important as baby boomers reach their golden years. By 2030, an estimated 72 million Americans will be 65 or over, nearly one-fifth of the U.S. population.

Medicare now reimburses doctors $86 to discuss end-of-life care in an office visit that covers topics such as hospice, living wills and do-not-resuscitate orders. Known as “advance care planning,” the conversations can also be held in a hospital.

The poll of 736 primary care doctors and specialists examined views on advance care planning and end-of-life conversations with patients. Among the findings:

  • While 75 percent of doctors said Medicare reimbursement makes it more likely they’d have advance care planning discussions, only about 14 percent said they had actually billed Medicare for those visits.
  • 75% also believe it’s their responsibility to initiate end-of-life conversations.
  • Fewer than one-third reported any formal training on end-of-life discussions with patients and their families, and more  than half said they had not discussed end-of-life care with their own physicians.