Monday, April 22, 2013

5 Misconceptions About Palliative Care

Richard Besdine, MD medical officer for the American Federation for Aging Research, has a terrific piece in the Huffington Post about palliative care and misconceptions about the field.  This is GeriPal to the core.  Please follow this link to read the full version.

As a tantalizing preview, here are the 5 misconceptions in brief:
  1. If you accept palliative care, you must stop treatment.
  2. Palliative care is the same as hospice.
  3. Electing palliative care means you are giving up.
  4. Palliative care shortens life expectancy.
  5. There isn't need for palliative care because my doctor will address pain anyway.
Sound familiar?

by: Alex Smith @alexsmithMD

3 comments:

gercare6@hotmail.com said...

Thank-you very much for Dr.Besdine's piece in the Huffington Post. Now, can we please inform the American public about Palliative Care in fewer years than the too many it took to inform them about Hospice Care. Steve G. Doncevic

Anonymous said...

If the federal and state governments would use the provisions of the 1991 Patient Self Determination Act (PSDA) to mandate informed consent for BOTH and/or EITHER Curative Care or Palliative Care/Hospice transition at EOL, the American public would be better served.

But the AMA didn't want to be put under the provisions of the PSDA in 1991 and have the legal obligation to SEEK informed consent for one of two legal standards of care approved for reimbursement by Medicare. Overtreatment for profit then became possible when physicians did not have the legal obligation to inform patients about the other legal standard of care reibursed by Medicare.

Obviously, palliative care and hospice is a cheaper standard of care to deliver but it provides less profit for the specialist physicians who often provide non-beneficial curative care that may or may not be reimbursed by Medicare under existing reimbursement protocols.

Such a mandate for informed consent would perhaps stop the epidemic of unilateral/defult DNRs that are a reaction to refusal to reimburse by CMS and the private insurers who deliver or supplement Medicare for profit.

Shouldn't geriatric physicians blow the whistle on behalf of geriatric patients?

James Sinclair said...

While the 5th reason makes sense we all know it is not going to happen. Disease modifying physicians have no time to palliate disease. I find reason 1-4 troublesome because they all center around fear and fear of death in particular. If palliative care is designed to allow or even promote that fear we are in big trouble!