Sunday, November 5, 2017

Physicians are missing the boat on ACP -Advance Care Planning

ACP/ Advance Care Planning is a part of our responsibility as conscientious physicians.
It is a part of the anticipatory guidance we offer patients just like smoking, drugs, alcohol, diet , weight control, accident prevention, vaccination etc.

It is up to us to bring up the question of ACP regarding end of life goals of living / the three questions as described in previous blogs here. We cannot wait for patients to be the initiators of the conversation.

Opportunities to do this are plenty., starting with regular well visits,(medicare even pays separately for it now) or at start of any illness, hospital admission, or with diagnosis of a life limiting illness, admission to hospital with it or even admission to the ICU.

The reason is obvious. Since life is so unpredictable, we have to talk to patients while they have capacity to make their own decisions.(since that capacity can be lost in a flash with trauma or illness.

Thus the sooner we get it done, the better. And better late than never.

If we do not talk to our patients regarding their end of life wishes while hey have capacity, then we have missed the boat!! This is a great disservice to the ones under our care.

In my experience with admitted patients only 30 % have any sort of advance directives /living wills.
We are missing the boat in at least 70% of our patients if we do not actively do this.