Physicians and the hospice decision: awareness, discussion, reasons and satisfaction.

Abstract

Two complementary studies examined dimensions of physicians’ involvement in the decision to enter hospice care. In Study 1, physicians practicing in three communities served by Medicare-certified hospices were surveyed by mail to determine their levels of awareness of hospice and the degree to which they discuss hospice with the terminally ill, and how these are affected by characteristics of their practice. Among the 45% who responded, over 90% were aware of hospice. In contrast, discussion of hospice was reported by only slightly over half. Nearly all comments about hospice (90%) were favorable. In Study 2, attending physicians of hospice patients were interviewed to determine their reasons for recommending hospice care, and their degrees of satisfaction with hospice. Aspects of support were identified as the most important reasons for recommending hospice; 97% of the physicians were satisfied with the decision that the patient enter hospice care. The gap between physicians’ awareness of hospice and their discussing it is examined, along with its implications. Issues for future research are identified.