Advance Care Planning Requires Training.

Abstract

See the Reply by Fulmer et al. We read with interest in the June issue the article by Fulmer and colleagues: “Physicians views on advance care planning and end-of-life care conversations.”1 This nationally representative survey of U.S. physicians found that, although 89% thought that advance care planning conversations are very or extremely important, 68% acknowledged that they had had no training specifically related to talking to patients and families about future medical decisions should the patient become unable to make decisions. The respondents agreed that the advent of Medicare reimbursement for these conversations reduced one barrier to their occurrence but also cited time pressures, “not knowing the right timing to have the conversation,” feeling that “the conversation might be uncomfortable,” and “not wanting to give up hope” as barriers. Those who reported receiving training in advance care planning and who had access to a formal assessment and documentation system were significantly more likely to participate in it. In response to these data and others like it, we have developed a 3-part on-line course aimed at physicians and other eligible providers providing training on what advance care planning is and why it matters; how to initiate and conduct these conversations using tested and proven methods; and how to document, accurately bill using the new codes, and develop supportive infrastructure to systematize their occurrence. With generous funding from the Gordon and Betty Moore Foundation, we will be able to offer these courses at low or no cost to professional membership organizations and associations across the country. We hope that they will begin to close the gap between physicians' understanding of the importance of this kind of communication and their actual participation in it. For more information, please contact Matthew Isbell, Business Development at [email protected]. Financial Disclosure: Funding was received from the Gordon and Betty Moore Foundation. Conflict of Interest: The authors report no conflicts of interest. Author Contributions: The text of the letter is the work of both authors. Sponsor's Role: The sponsor had no role in the content.