Title

Legal and Policy Implications of Physicians Counseling Minority Patients Regarding Their End-of-Life Care Choices

Location

Atlanta, Ga.

Publication Date / Copyright Date

11-7-2017

Abstract

he graying of America and recognition of access and quality problems in end-of-life (EOL) care have resulted in recognition of EOL care as a public health issue. Proper communication between physician and patient is essential to ensure that patients have an appropriate understanding of end-of-life (EOL) care. Medicare has implemented a possible solution to this problem by reimbursing physicians for end-of-life counseling with patients. However, less than 30% of physicians say that counseling is taking place. Multiple factors such as physician’s training and patient’s attitudes and lack of basic knowledge regarding care options at the end of life affect proper physician/patient communication resulting in inadequate access, quality and cost outcomes for end of life care. A research study conducted in South Florida to understand current attitudes toward and knowledge of key EOL concepts supported those findings. Results from the study showed a statistically significant link between lower education levels and reduced knowledge of EOL options. The study also showed that racial and ethnic minorities in South Florida had a statistically significant lower knowledge base about hospice care and terminal illness than Caucasians. These findings seem to suggest that some patients may require more education and counseling about EOL care options than others do, in order to give truly informed consent to their EOL care. We will explore possible barriers to the application of the reimbursement law, including “right to know” laws, time constraints and lack of training for physicians to counsel patients and knowledge and attitude barriers from patients.

Disciplines

Medicine and Health Sciences

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